What is it about?
Extracorporeal membrane oxygenation (ECMO) is a life-support technique for patients whose lungs and/or heart are failing: blood is pumped out through large cannulae, oxygenated in an artificial lung and returned to the body. Infections are among its most common complications and markedly increase mortality. In this narrative review we summarize what is known about infections during ECMO. About 10-12% of patients develop a hospital-acquired infection, more often than other critically ill patients. The most frequent germs are coagulase-negative staphylococci, Candida, Enterobacteriaceae and Pseudomonas aeruginosa. Ventilator-associated pneumonia is particularly common. The longer a patient stays on ECMO, the higher the risk. Other contributing factors include the severity of illness, bacterial translocation from the gut, ECMO-related impairment of the immune system and colonization of catheters, cannulae and the oxygenator.
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Photo by Bagoes Ilhamy on Unsplash
Why is it important?
ECMO use has grown rapidly, but infection prevention in these patients is still poorly standardized. This review gives intensivists and infectious diseases specialists a clear overview of the epidemiology, risk factors and mechanisms of ECMO-related infections, supporting better prevention, diagnosis and antibiotic choices.
Perspectives
ECMO patients are among the most complex we consult on, and diagnosing infection in them is particularly tricky. Writing this review with intensive care colleagues helped us bring order to a scattered literature and to define practical priorities for prevention.
Professor Stefano Di Bella
Universita degli Studi di Trieste
Read the Original
This page is a summary of: Infections during extracorporeal membrane oxygenation: epidemiology, risk factors, pathogenesis and prevention, International Journal of Antimicrobial Agents, July 2017, Elsevier,
DOI: 10.1016/j.ijantimicag.2017.02.025.
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