The nosocomial infection status in postcardiotomy patients supported with extracorporeal membrane oxygenation：a retrospective observational study / 中华胸心血管外科杂志

ABSTRACT

Objective To investigate the nosocomial infection status in adult patients after cardiac surgery , who suffered cardiac shock and were supported with extracorporeal membrane oxygenation(ECMO).Methods The data of this retrospec-tive analysis were collected from adult patients of postoperative cardiac shock supported with veno-arterial( VA) ECMO from January 2011 to December 2013 in the Center for Cardiac Intensive Care, Beijing Anzhen Hospital.Results 125 patients were enrolled and nosocomial infection occured in 44 patients(51 episodes), infection rate was 35.2% or 71.8 episodes per 1 000 ECMO day.Respiratory tract infection occured most(27.2%), and then bloodstream infection(12.8%).The infection increased in the extension of time.The cultivation of the phlegm and blood specimen showed that the major pathogens were gram-negative bacteria.The patients were divided into the infection and the non-infection groups, the incidence of remedially continuous renal replacement therapy were significantly higher in the infection group than that in the non-infection group and the duration of ECMO support, the lenth of postoperative hospital stay, and the lenth of ICU stay were significantly longer in the in-fection group than those in the non-infection group[40.9% vs.22.2%, P<0.05; (7.2 ±4.6) d vs.(4.9 ±2.1) d, P<0.01;(12.5 ±6.2) d vs.(9.1 ±4.9) d, P<0.01和24(13, 36) d vs.15(11,20) d, P<0.01; respectively].The pa-tients in the infection group had higher mortality compared with the patients in the non-infection group(53.5% vs.17.1%, P<0.01).Conclusion Nosocomial infection is one of the common complications of the ECMO treatment and affects the prognosis of patients.The strict aseptic technique and rational application of antibiotics may reduce the mortality .