초록접수 현황
| 16F-034 | 구연 발표 |
Nosocomial Infection in Adult Patients Undergoing Veno-arterial Extracorporeal Membrane Oxygenation
Gwan Sic Kim, Kyo Seon Lee,, Seung Ku Kang, Do Wan Kim, Sang Gi Oh, Bong-Suk Oh, Yochun Jung, Seok Kim, Ju Sik Yun, Sang Yun Song, Kook Joo Na, Byoung Hee Ahn, In Seok Jeong
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Korea
Background : Data on the frequency of nosocomial infections during ECMO in adult populations remain scarce. We investigated the risk factors for nosocomial infections in adult patients undergoing venoarterial extracorporeal membrane oxygenation (ECMO) support.
Methods : From January 2011 to December 2015, a total of 259 patients underwent extracorporeal membrane oxygenation. Of these, patients aged 17 years or less and patients undergoing extracorporeal membrane oxygenation for less than 48 h were excluded. Of these, 61 patients diagnosed with cardiogenic shock were evaluated.
Results : Mean patient age was 60.6 ± 14.3 years and 21 (34.4%) patients were female. The mean preoperative Sequential Organ Failure Assessment (SOFA) score was 8.6 ± 2.2. The mean duration of ECMO support was 6.8 ± 7.4 days. The rates of successful ECMO weaning and survival to discharge were 44.3% and 31.1%, respectively. There were 18 nosocomial infections in 14 (23.0%) patients. These included respiratory tract infections (RTIs) in nine cases and bloodstream infections (BSIs) in a further nine. In multivariate analysis, independent predictors of infection during ECMO were the preoperative creatinine level (HR: 2.176, 95% CI 1.065-4.447, P=0.033) and the duration of ECMO support (HR: 1.400, 95% CI 1.081-1.815, P=0.011).
Conclusion : A higher preoperative creatinine level and an extended duration of ECMO support were risk factors for infection. Therefore, strategies to shorten the length of ECMO support should be applied whenever possible and close monitoring may be helpful to avoid the development of nosocomial infections.
Methods : From January 2011 to December 2015, a total of 259 patients underwent extracorporeal membrane oxygenation. Of these, patients aged 17 years or less and patients undergoing extracorporeal membrane oxygenation for less than 48 h were excluded. Of these, 61 patients diagnosed with cardiogenic shock were evaluated.
Results : Mean patient age was 60.6 ± 14.3 years and 21 (34.4%) patients were female. The mean preoperative Sequential Organ Failure Assessment (SOFA) score was 8.6 ± 2.2. The mean duration of ECMO support was 6.8 ± 7.4 days. The rates of successful ECMO weaning and survival to discharge were 44.3% and 31.1%, respectively. There were 18 nosocomial infections in 14 (23.0%) patients. These included respiratory tract infections (RTIs) in nine cases and bloodstream infections (BSIs) in a further nine. In multivariate analysis, independent predictors of infection during ECMO were the preoperative creatinine level (HR: 2.176, 95% CI 1.065-4.447, P=0.033) and the duration of ECMO support (HR: 1.400, 95% CI 1.081-1.815, P=0.011).
Conclusion : A higher preoperative creatinine level and an extended duration of ECMO support were risk factors for infection. Therefore, strategies to shorten the length of ECMO support should be applied whenever possible and close monitoring may be helpful to avoid the development of nosocomial infections.
첨부파일 : Table.doc
책임저자: In Seok Jeong
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Korea
발표자: Gwan Sic Kim, E-mail : lovingmylife@naver.com