2026-06-28T10:28:23Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/1048642025-03-18T14:47:10Zcom_20.500.14352_14col_20.500.14352_15

00925njm 22002777a 4500 dc Mornese Pinna, Simone author Sousa Casasnovas, Iago author Olmedo, María author Machado, Marina author Juàrez Fernández, Miriam author Devesa Cordero, Carolina author Galar, Alicia author Álvarez Uría, Ana author Fernández Avilés, Francisco author García Carreño, Jorge author Martínez-Sellés D Oliveira Soares, Manuel author De Rosa, Francesco Giuseppe author Corcione, Silvia author Bouza Santiago, Emilio author Muñoz García, Patricia Carmen author Valerio Minero, Maricela author 2023-04-20 The use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in-hospital mortality due to nosocomial infections in patients with ECMO admitted to a single coronary intensive care unit between July 2013 and March 2019 treated with VA-ECMO for >48 h. From 69 patients treated with VA-ECMO >48 h, (median age 58 years), 29 (42.0%) patients developed 34 episodes of infections with an infection rate of 0.92/1000 ECMO days. The most frequent were ventilator-associated pneumonia (57.6%), tracheobronchitis (9.1%), bloodstream infections (9.1%), skin and soft tissue infections (9.1%), and cytomegalovirus reactivation (9.1%). In-hospital mortality was 47.8%, but no association with nosocomial infections was found (p = 0.75). The number of days on ECMO (OR 1.14, 95% CI 1.01–1.30, p = 0.029) and noninfectious complications were higher in the infected patients (OR: 3.8 95% CI = 1.05–14.1). A higher baseline creatinine value (OR: 8.2 95% CI = 1.12–60.2) and higher blood lactate level at 4 h after ECMO initiation (OR: 2.0 95% CI = 1.23–3.29) were significant and independent risk factors for mortality. Conclusions: Nosocomial infections in medical patients treated with VA-ECMO are very frequent, mostly Gram-negative respiratory infections. Preventive measures could play an important role for these patients. Mornese Pinna S, Sousa Casasnovas I, Olmedo M, Machado M, Juàrez Fernández M, Devesa-Cordero C, et al. Nosocomial Infections in Adult Patients Supported by Extracorporeal Membrane Oxygenation in a Cardiac Intensive Care Unit. Microorganisms. 2023;11(4):1079 10.3390/microorganisms11041079 https://hdl.handle.net/20.500.14352/104864 2076-2607 https://doi.org/10.3390/microorganisms11041079 Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit