Abstract
The use of venoarterial ECMO (VA-ECMO) is common in Cardiovascular Critical Care Units (CCCUs), although these devices can lead to various complications.. The aim of this study is to analyze infectious complications (IC) in patients with peripheral ECMO-VA via percutaneous insertion and to identify potential related factors.
We performed a retrospective analysis of a prospective registry of patients admitted to the CCU with peripheral VA-ECMO between January 2023 and April 2024. Body temperature was monitored for a minimum of 72 hours in all patients, and the criteria from the European Centre for Disease Prevention and Control were used for the diagnosis of infections.
Of the 32 patients implanted with ECMO-VA, 27 were included in the analysis [Table 1A]. Three were excluded as a result of an ongoing infection prior to implantation and two because of insufficient data. All implants were performed using percutaneous techniques in the catheterization laboratory, with 70% occurring during cardiac arrest. The survival rate at discharge from the CCCU was 48.1%, with 61.5% reflecting normal neurological condition (CPC 1). All patients received antibiotic prophylaxis at the time of implantation. The most commonly prescribed antibiotic was daptomycin (88.9%) [Figure 1A]. Thirteen patients (48.1%) developed an infection at a median of 6 days (3-10), with nosocomial pneumonia being the most frequent (60%), followed by sepsis (40%). No infections were documented at the cannula insertion site. 76.9% of the infections had confirmed microbiological diagnoses. The association of different clinical and analytical variables with the development of infection was analyzed [Table 1B]. Neither C-reactive protein (CRP) nor procalcitonin (PCT) showed differences between groups. The timing of ECMO withdrawal was connected to a reduced occurrence of infections
Author notes
Funding Acknowledgements: None.
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