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Infections during extracorporeal life support
1Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock 72202-3591, USA.
Journal of Pediatric Surgery
|June 1, 1995
Summary
Patients on prolonged extracorporeal life support (ECLS) face a high risk of nosocomial infections, particularly fungal types. Increased awareness and further research into preventative strategies are crucial for improving outcomes in these critically ill patients.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Cardiovascular Surgery
Background:
- Limited data exist regarding the types of infections acquired during extracorporeal life support (ECLS).
- Nosocomial infections pose a significant threat to patients undergoing advanced life support interventions.
Purpose of the Study:
- To investigate the incidence, types, and outcomes of nosocomial infections in patients receiving venoarterial extracorporeal life support (VA-ECLS).
Main Methods:
- Retrospective analysis of 109 patients undergoing 115 episodes of VA-ECLS.
- Data collected on infection development, duration of support, chest status, and causative organisms.
Main Results:
- Nosocomial infections occurred in 16% of patients, with longer support durations and open chests being significant risk factors.
- Blood-borne infections were common during cannulation, while urinary tract and wound infections occurred post-decannulation.
- Fungal organisms were isolated in 50% of infections, associated with a higher case-fatality rate compared to bacterial infections.
Conclusions:
- Patients on prolonged VA-ECLS require heightened vigilance for nosocomial infections.
- Further research into antifungal prophylaxis and immune modulation is warranted to mitigate infection risks and improve survival rates.