Clinical risk factors of hospital-acquired infections in the patients treated with extracorporeal cardiopulmonary resuscitation during ECMO support
Zhou Hao
Ding Tao
Shi Yutong
Zhang Zhongman
Zhu Yi
Chen Xufeng
Li Wei
Abstract：Objective To explore the risk factors of hospital-acquired infections(HAI)in the patients with extracorporeal cardiopulmonary resuscitation(ECPR)during extracorporeal membrane oxygenation(ECMO)support.Methods Clinical data of 83 ECPR patients in Extracorporeal Life Support Center of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.The patients were divided into HAI group(n=35)and non-HAI(nHAI,n=48)group according to whether microorganisms were isolated from body fluid culture,and the baseline characteristics,laboratory test and prognosis between the two groups were compared.The independent influencing factors of HAI occurrence were explored by stepwise Logistic regression analysis.Results The incidence of HAI in 83 ECPR patients was 42.2％.The rank sum test indicated that in the HAI group,ECMO catheterization time[min:30.0(22.5,40.0)vs.23.5(16.5,30.0)],hospitalization days[d:15.0(10.5,25.5)vs.9.5(4.0,19.3)],ICU days[d:13.0(9.0,21.5)vs.7.0(3.8,13.0)],duration of ECMO support[d:6.0(5.1,7.9)vs.5.0(3.2,6.7)]and duration of invasive mechanical ventilation(IMV)[d:11.0(7.0,13.0)vs.5.0(3.0,9.0)]were longer than those in nHAI group(all P＜0.05).Chi-square test showed that the 28-day mortality(60.0％vs.37.5％,P=0.043)and the probability of tracheotomy(25.7％vs.4.2％,P=0.011)in the HAI group were higher than those in the nHAI group.Multivariate stepwise binary Logistic regression analysis showed that IMV≥7 days was independently correlated with HAI(OR=5.016,95％CI 1.659-15.168,P=0.004).Conclusions The occurrence of HAI during ECMO support in ECPR patients may be associated with poor prognosis,and our study finds that HAI is independently associated with IMV≥7 days.
Keywords：Extracorporeal cardiopulmonary resuscitationExtracorporeal membrane oxygenationHospital-acquired infectionsPrognosisInvasive mechanical ventilation
Publication Date：2024-11-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 938-942 )