Epidemiology of Infectious Complications During Extracorporeal Membrane Oxygenation in Children: A Single-Center Experience in 46 Runs

Elio Castagnola, Livia Gargiullo, Anna Loy, Paola Tatarelli, Ilaria Caviglia, Roberto Bandettini, Chiara Grasso, Elisabetta Lampugnani, Stefano Pezzato, Pietro Tuo, Andrea Moscatelli

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Abstract

BACKGROUND: Infections represent a severe complication of extracorporeal membrane oxygenation (ECMO). Aim of the present study was to describe the epidemiology of infections acquired during ECMO in a tertiary care children's hospital.METHODS: Retrospective analysis of clinical records of patients undergoing ECMO between January 2009 and December 2016. For each patient, data were collected on clinical characteristics, modality of ECMO support, site and etiology of documented infections, survival within 1 week after ECMO weaning and/or at pediatric intensive care unit discharge. These data were employed to evaluate overall infection prevalence, infection rate expressed as episodes/1000 days of support and cumulative risk estimates of infections occurring during ECMO.RESULTS: During the study period, a total of 46 ECMO procedures were performed. The overall prevalence of documented infections was 33%, with an infection rate of 27.22 and a cumulative risk of 55%. Bloodstream infection represented the most frequently documented (53%), followed by pneumonia (40%). Coagulase-negative staphylococci and Pseudomonas aeruginosa prevailed as isolated pathogens. Overall survival was 59%, and 46% among those developing infections during ECMO.CONCLUSIONS: ECMO is a procedure at high risk for infections. Our data, limited to 1 center, represent a recent benchmark for further investigations.
Original languageEnglish
Pages (from-to)624-626
Number of pages3
JournalPediatric Infectious Disease Journal
Volume37
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

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Extracorporeal Membrane Oxygenation
Epidemiology
Infection
Benchmarking
Pediatric Intensive Care Units
Survival
Coagulase
Tertiary Healthcare
Weaning
Staphylococcus
Pseudomonas aeruginosa
Pneumonia

Cite this

@article{d6ad1c985ab04268bbc9c0cbe89738b2,
title = "Epidemiology of Infectious Complications During Extracorporeal Membrane Oxygenation in Children: A Single-Center Experience in 46 Runs",
abstract = "BACKGROUND: Infections represent a severe complication of extracorporeal membrane oxygenation (ECMO). Aim of the present study was to describe the epidemiology of infections acquired during ECMO in a tertiary care children's hospital.METHODS: Retrospective analysis of clinical records of patients undergoing ECMO between January 2009 and December 2016. For each patient, data were collected on clinical characteristics, modality of ECMO support, site and etiology of documented infections, survival within 1 week after ECMO weaning and/or at pediatric intensive care unit discharge. These data were employed to evaluate overall infection prevalence, infection rate expressed as episodes/1000 days of support and cumulative risk estimates of infections occurring during ECMO.RESULTS: During the study period, a total of 46 ECMO procedures were performed. The overall prevalence of documented infections was 33{\%}, with an infection rate of 27.22 and a cumulative risk of 55{\%}. Bloodstream infection represented the most frequently documented (53{\%}), followed by pneumonia (40{\%}). Coagulase-negative staphylococci and Pseudomonas aeruginosa prevailed as isolated pathogens. Overall survival was 59{\%}, and 46{\%} among those developing infections during ECMO.CONCLUSIONS: ECMO is a procedure at high risk for infections. Our data, limited to 1 center, represent a recent benchmark for further investigations.",
author = "Elio Castagnola and Livia Gargiullo and Anna Loy and Paola Tatarelli and Ilaria Caviglia and Roberto Bandettini and Chiara Grasso and Elisabetta Lampugnani and Stefano Pezzato and Pietro Tuo and Andrea Moscatelli",
year = "2018",
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day = "1",
doi = "10.1097/INF.0000000000001873",
language = "English",
volume = "37",
pages = "624--626",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
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TY - JOUR

T1 - Epidemiology of Infectious Complications During Extracorporeal Membrane Oxygenation in Children: A Single-Center Experience in 46 Runs

AU - Castagnola, Elio

AU - Gargiullo, Livia

AU - Loy, Anna

AU - Tatarelli, Paola

AU - Caviglia, Ilaria

AU - Bandettini, Roberto

AU - Grasso, Chiara

AU - Lampugnani, Elisabetta

AU - Pezzato, Stefano

AU - Tuo, Pietro

AU - Moscatelli, Andrea

PY - 2018/7/1

Y1 - 2018/7/1

N2 - BACKGROUND: Infections represent a severe complication of extracorporeal membrane oxygenation (ECMO). Aim of the present study was to describe the epidemiology of infections acquired during ECMO in a tertiary care children's hospital.METHODS: Retrospective analysis of clinical records of patients undergoing ECMO between January 2009 and December 2016. For each patient, data were collected on clinical characteristics, modality of ECMO support, site and etiology of documented infections, survival within 1 week after ECMO weaning and/or at pediatric intensive care unit discharge. These data were employed to evaluate overall infection prevalence, infection rate expressed as episodes/1000 days of support and cumulative risk estimates of infections occurring during ECMO.RESULTS: During the study period, a total of 46 ECMO procedures were performed. The overall prevalence of documented infections was 33%, with an infection rate of 27.22 and a cumulative risk of 55%. Bloodstream infection represented the most frequently documented (53%), followed by pneumonia (40%). Coagulase-negative staphylococci and Pseudomonas aeruginosa prevailed as isolated pathogens. Overall survival was 59%, and 46% among those developing infections during ECMO.CONCLUSIONS: ECMO is a procedure at high risk for infections. Our data, limited to 1 center, represent a recent benchmark for further investigations.

AB - BACKGROUND: Infections represent a severe complication of extracorporeal membrane oxygenation (ECMO). Aim of the present study was to describe the epidemiology of infections acquired during ECMO in a tertiary care children's hospital.METHODS: Retrospective analysis of clinical records of patients undergoing ECMO between January 2009 and December 2016. For each patient, data were collected on clinical characteristics, modality of ECMO support, site and etiology of documented infections, survival within 1 week after ECMO weaning and/or at pediatric intensive care unit discharge. These data were employed to evaluate overall infection prevalence, infection rate expressed as episodes/1000 days of support and cumulative risk estimates of infections occurring during ECMO.RESULTS: During the study period, a total of 46 ECMO procedures were performed. The overall prevalence of documented infections was 33%, with an infection rate of 27.22 and a cumulative risk of 55%. Bloodstream infection represented the most frequently documented (53%), followed by pneumonia (40%). Coagulase-negative staphylococci and Pseudomonas aeruginosa prevailed as isolated pathogens. Overall survival was 59%, and 46% among those developing infections during ECMO.CONCLUSIONS: ECMO is a procedure at high risk for infections. Our data, limited to 1 center, represent a recent benchmark for further investigations.

U2 - 10.1097/INF.0000000000001873

DO - 10.1097/INF.0000000000001873

M3 - Article

VL - 37

SP - 624

EP - 626

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 7

ER -