Infection dynamics and management in patients undergoing extracorporeal membrane oxygenation: a retrospective analysis.

Abstract

Introduction: The aim of this study was to summarize the infection situation of patients during extracorporeal membrane oxygenation (ECMO) treatment, and analyze the relevant infectious indexes before and after ECMO treatment; so as to provide clinical evidence for the control of infection after ECMO treatment.

Methodology: A retrospective analysis was conducted from May 2014 to January 2024 on 66 patients treated with ECMO at the Department of Intensive Care Medicine, Daping Hospital, Army Medical University. The patients' general clinical data were collected, focusing on infection types, pathogenic bacteria, anti-infective regimens, infection markers, and coagulation function. Additionally, risk factors for infection in intensive care unit (ICU) patients undergoing ECMO treatment were analyzed.

Results: Pulmonary infections were the most common among the patients in this study, and Gram-negative bacilli were the predominant pathogens. Significant reductions were observed in white blood cell count (p < 0.05, n = 57), platelet count (p < 0.05, n = 56), and fibrinogen levels (p < 0.05, n = 57) 48 hours after ECMO treatment. Of the 66 ECMO patients, 30 survived. The length of stay in the ICU was identified as an independent risk factor for adverse events following ECMO treatment.

Conclusions: Controlling infection during ECMO is the cornerstone of survival and prognosis of patients. Mechanical ventilation time, continuous renal replacement therapy, central venous catheterization time, and antibiotic treatment time may be related to infection after ECMO. Early bacterial culture; and prophylactic, empirical, and targeted antimicrobials contribute to infection control.