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Infection profile of patients with extracorporeal membrane oxygenation in paediatric cardiac surgery ICU

Published online by Cambridge University Press:  28 April 2022

Mehmet Emirhan Işık ,
Ergin Arslanoğlu ,
Şirin Menekşe ,
Yeşim Uygun-Kızmaz ,
Ömer Faruk Şavluk ,
Kenan Abdurrahman Kara Open the ORCID record for Kenan Abdurrahman Kara [Opens in a new window] ,
Aysu Türkmen-Karaağaç  and
Hakan Ceyran
Mehmet Emirhan Işık*
Affiliation:
Department of Infectious Diseases, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
Ergin Arslanoğlu
Affiliation:
Department of Pediatric Cardiovascular Surgery, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
Şirin Menekşe
Affiliation:
Department of Infectious Diseases, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
Yeşim Uygun-Kızmaz
Affiliation:
Department of Infectious Diseases, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
Ömer Faruk Şavluk
Affiliation:
Department of Anesthesiology and Reanimation, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
Kenan Abdurrahman Kara
Affiliation:
Department of Pediatric Cardiovascular Surgery, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
Aysu Türkmen-Karaağaç
Affiliation:
Department of Pediatric, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
Hakan Ceyran
Affiliation:
Department of Pediatric Cardiovascular Surgery, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey
*
Author for correspondence: Dr M. E. Işık, Department of Infectious Diseases, Kartal Kosuyolu Training and Research Hospital, İstanbul, Turkey. Tel: +905052711861. E-mail: [email protected]
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Abstract

Aim:

We investigated the risk of increased nosocomial infections and the associated pathogens in patients who underwent paediatric cardiovascular surgery and were put on extracorporeal membrane oxygenation support. We studied the duration of extracorporeal membrane oxygenation use and other variables that may be associated with increased nosocomial infection risk.

Methods:

Patients who were treated with an extracorporeal membrane oxygenation in paediatric cardiovascular surgery ICU between 2010 and 2020 were included in this retrospective study. We analysed the site of infection and microbiological profile of infections occurring in these patients according to CDC and National Healthcare Safety Network criteria.

Results:

The onset of infection development in patients after extracorporeal membrane oxygenation was found to be median 8 (3–15, 25–75 IQR) days in the whole group, and median 11 (3–16, 25–75 IQR) days in those who developed infection without being put on extracorporeal membrane oxygenation. When patients were divided into those with and without infection, duration of ICU was found to be 19 (16–28, IQR 25–75) days in patients with infection vs. 8 (2–16, IQR 25–75; p: <0.001) days in patients without infection. Duration of extracorporeal membrane oxygenation support was found to be 14 (10–25, IQR 25–75) days in patients with infection versus 5 (2–10, IQR 25–75; p: <0.001) days in patients without infection and total hospital stay was 26 (18–33, IQR 25–75) days in patients with infection versus 8 (2–23, IQR 25–75) days in those without infection. A total of 24 patients out of the 70 patients experienced 32 infectious episodes during extracorporeal membrane oxygenation support. Culture-positive infections were detected at a single site in 19 patients, and multiple sites in 5 patients.

Conclusion:

We propose that prolonged extracorporeal membrane oxygenation support is associated with an increased risk of infection. Although extracorporeal membrane oxygenation is a life-saving treatment method, prolonged extracorporeal membrane oxygenation may increase the development of infectious complications and the associated mortality and morbidity of the patient.

Keywords

Extracorporeal membrane oxygenationpediatric cardiovascular surgerynosocomial infections
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 11 , November 2022 , pp. 1833 - 1838
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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