RESUMO
INTRODUCCIÓN: El objetivo de este estudio es analizar la incidencia de infección en los niños tratados con ECMO, el tratamiento y su evolución. MÉTODOS: Se realizó un estudio retrospectivo basado en una base de datos prospectiva en el que se incluyeron los niños menores de 18 años asistidos con ECMO entre septiembre de 2006 y noviembre de 2015. Se recogieron las características de los pacientes, la ECMO, los cultivos y el tratamiento de la infección. RESULTADOS: Se estudiaron 100 pacientes de 11 meses de edad mediana. El diagnóstico fue de cardiopatía en 94 pacientes. Se sospechó una infección y se inició antibioterapia en 51 pacientes, aunque solo se confirmó microbiológicamente en 22. Las infecciones más frecuentes fueron la sepsis (49%), neumonía (35,3%) e infección urinaria (9,8%). No existieron diferencias en los parámetros hematológicos y reactantes de fase aguda entre los niños con infección y el resto. Los niños que fallecieron presentaron mayor incidencia, no estadísticamente significativa, de infección durante la ECMO (60,4%) que los supervivientes (40,3%) (p = 0,07). La duración de ingreso en la UCIP fue mayor, sin significación estadística, en los pacientes con infección que en el resto: 57 frente a 37 días (p = 0,067). CONCLUSIONES: La frecuencia de infección en niños con ECMO es elevada, pero menos de la mitad son confirmadas microbiológicamente, sin existir parámetros específicos de infección. No se ha encontrado relación estadísticamente significativa de la infección con la mortalidad y la duración de ingreso en la UCIP
INTRODUCTION: The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO. METHODS: A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients' clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection. RESULTS: One hundred patients with a median age of 11 months were analysed. Heart disease was diagnosed in 94 patients. An infection was suspected and antibiotic treatment was initiated in 51 patients, although only 22 of them were microbiologically confirmed. The most common infection was sepsis (49%), followed by pneumonia (35.3%) and urinary tract infection (9.8%). There were no differences in haematological parameters and acute phase reactants between children with infection and those without. Children who died had a higher incidence of infection during ECMO (60.4%) than the survivors (40.3%), but the difference did not reach statistical significance (P = .07). The duration of admission in the PICU was 57 days in patients with infection vs 37 days in patients without infection but the difference was not statistically significant (P = .067). CONCLUSIONS: Infection in children with ECMO is common. There are no specific infection parameters and less than half of the clinical infections are confirmed microbiologically. There was no statistically significant correlation between infection and mortality or duration of PICU stay
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Oxigenação por Membrana Extracorpórea/efeitos adversos , Infecção Hospitalar/etiologia , Estudos Retrospectivos , Estudo Observacional , Fatores de Risco , IncidênciaRESUMO
INTRODUCTION: The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO. METHODS: A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients' clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection. RESULTS: One hundred patients with a median age of 11 months were analysed. Heart disease was diagnosed in 94 patients. An infection was suspected and antibiotic treatment was initiated in 51 patients, although only 22 of them were microbiologically confirmed. The most common infection was sepsis (49%), followed by pneumonia (35.3%) and urinary tract infection (9.8%). There were no differences in haematological parameters and acute phase reactants between children with infection and those without. Children who died had a higher incidence of infection during ECMO (60.4%) than the survivors (40.3%), but the difference did not reach statistical significance (P=.07). The duration of admission in the PICU was 57 days in patients with infection vs 37 days in patients without infection but the difference was not statistically significant (P=.067). CONCLUSIONS: Infection in children with ECMO is common. There are no specific infection parameters and less than half of the clinical infections are confirmed microbiologically. There was no statistically significant correlation between infection and mortality or duration of PICU stay.
