Abstract
Introduction: Veno-arterial extracorporeal membrane oxygenation after heart surgery is a relatively common procedure. It is easily applicable but associated with a number of complications, including bloodstream infections. The aim of this study is to determine the current rate and the risk factors related to bloodstream infections acquired during post-cardiotomy veno-arterial extracorporeal membrane oxygenation. Methods: Single-center retrospective study. From the overall population receiving any kind of extracorporeal membrane oxygenation from March 2013 through December 2017, the post-cardiotomy patient population was extracted, with a final sample of 92 veno-arterial extracorporeal membrane oxygenations. The risk of developing bloodstream infections as a function of extracorporeal membrane oxygenation exposure was analyzed with appropriate statistical analyses, including a Kaplan–Meier analysis. Results: Overall, 14 (15.2%) patients developed a bloodstream infection during extracorporeal membrane oxygenation or within the first 48 h after extracorporeal membrane oxygenation removal. The total extracorporeal membrane oxygenation duration in the population was 567 days, and the incidence of bloodstream infections was 24.7 bloodstream infections/1000 extracorporeal membrane oxygenation days. There was a progressive increase in the cumulative hazard ratio during the first 7 days, reaching a value of 20% on day 7; from day 7 and day 15, the hazard ratio remained stable, with a second increase after day 15. The independent risk factors associated with bloodstream infections were adult age, pre-implantation serum total bilirubin level, and the amount of chest drain blood loss. Discussion: Infections acquired during veno-arterial extracorporeal membrane oxygenation are common. Identify the risk factors that may improve strategies for treatment and prevention.
| Original language | English |
|---|---|
| Journal | International Journal of Artificial Organs |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- bleeding
- cardiac surgery
- Extracorporeal membrane oxygenation
- infection
- risk factors
ASJC Scopus subject areas
- Bioengineering
- Medicine (miscellaneous)
- Biomaterials
- Biomedical Engineering
Cite this
Bloodstream infections during post-cardiotomy extracorporeal membrane oxygenation : Incidence, risk factors, and outcomes. / Silvetti, Simona; Ranucci, Marco; Pistuddi, Valeria; Isgrò, Giuseppe; Ballotta, Andrea; Ferraris, Laurenzia; Cotza, Mauro.
In: International Journal of Artificial Organs, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bloodstream infections during post-cardiotomy extracorporeal membrane oxygenation
T2 - Incidence, risk factors, and outcomes
AU - Silvetti, Simona
AU - Ranucci, Marco
AU - Pistuddi, Valeria
AU - Isgrò, Giuseppe
AU - Ballotta, Andrea
AU - Ferraris, Laurenzia
AU - Cotza, Mauro
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Introduction: Veno-arterial extracorporeal membrane oxygenation after heart surgery is a relatively common procedure. It is easily applicable but associated with a number of complications, including bloodstream infections. The aim of this study is to determine the current rate and the risk factors related to bloodstream infections acquired during post-cardiotomy veno-arterial extracorporeal membrane oxygenation. Methods: Single-center retrospective study. From the overall population receiving any kind of extracorporeal membrane oxygenation from March 2013 through December 2017, the post-cardiotomy patient population was extracted, with a final sample of 92 veno-arterial extracorporeal membrane oxygenations. The risk of developing bloodstream infections as a function of extracorporeal membrane oxygenation exposure was analyzed with appropriate statistical analyses, including a Kaplan–Meier analysis. Results: Overall, 14 (15.2%) patients developed a bloodstream infection during extracorporeal membrane oxygenation or within the first 48 h after extracorporeal membrane oxygenation removal. The total extracorporeal membrane oxygenation duration in the population was 567 days, and the incidence of bloodstream infections was 24.7 bloodstream infections/1000 extracorporeal membrane oxygenation days. There was a progressive increase in the cumulative hazard ratio during the first 7 days, reaching a value of 20% on day 7; from day 7 and day 15, the hazard ratio remained stable, with a second increase after day 15. The independent risk factors associated with bloodstream infections were adult age, pre-implantation serum total bilirubin level, and the amount of chest drain blood loss. Discussion: Infections acquired during veno-arterial extracorporeal membrane oxygenation are common. Identify the risk factors that may improve strategies for treatment and prevention.
AB - Introduction: Veno-arterial extracorporeal membrane oxygenation after heart surgery is a relatively common procedure. It is easily applicable but associated with a number of complications, including bloodstream infections. The aim of this study is to determine the current rate and the risk factors related to bloodstream infections acquired during post-cardiotomy veno-arterial extracorporeal membrane oxygenation. Methods: Single-center retrospective study. From the overall population receiving any kind of extracorporeal membrane oxygenation from March 2013 through December 2017, the post-cardiotomy patient population was extracted, with a final sample of 92 veno-arterial extracorporeal membrane oxygenations. The risk of developing bloodstream infections as a function of extracorporeal membrane oxygenation exposure was analyzed with appropriate statistical analyses, including a Kaplan–Meier analysis. Results: Overall, 14 (15.2%) patients developed a bloodstream infection during extracorporeal membrane oxygenation or within the first 48 h after extracorporeal membrane oxygenation removal. The total extracorporeal membrane oxygenation duration in the population was 567 days, and the incidence of bloodstream infections was 24.7 bloodstream infections/1000 extracorporeal membrane oxygenation days. There was a progressive increase in the cumulative hazard ratio during the first 7 days, reaching a value of 20% on day 7; from day 7 and day 15, the hazard ratio remained stable, with a second increase after day 15. The independent risk factors associated with bloodstream infections were adult age, pre-implantation serum total bilirubin level, and the amount of chest drain blood loss. Discussion: Infections acquired during veno-arterial extracorporeal membrane oxygenation are common. Identify the risk factors that may improve strategies for treatment and prevention.
KW - bleeding
KW - cardiac surgery
KW - Extracorporeal membrane oxygenation
KW - infection
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85060113058&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060113058&partnerID=8YFLogxK
U2 - 10.1177/0391398818817325
DO - 10.1177/0391398818817325
M3 - Article
AN - SCOPUS:85060113058
JO - International Journal of Artificial Organs
JF - International Journal of Artificial Organs
SN - 0391-3988
ER -