https://scholars.lib.ntu.edu.tw/handle/123456789/589253
標題: | Infections occurring during extracorporeal membrane oxygenation use in adult patients | 作者: | HSIN-YUN SUN Ko W.-J. Tsai P.-R. Sun C.-C. Chang Y.-Y. Lee C.-W. YEE-CHUN CHEN |
公開日期: | 2010 | 出版社: | Mosby Inc. | 卷: | 140 | 期: | 5 | 起(迄)頁: | 1125-1132.e2 | 來源出版物: | Journal of Thoracic and Cardiovascular Surgery | 摘要: | Objective: The application of extracorporeal membrane oxygenation in adults has been increasing, but infections occurring during extracorporeal membrane oxygenation use are rarely described. Methods: We retrospectively analyzed the prospectively collected data on nosocomial infection surveillance of 334 patients aged 16 years or more undergoing their first extracorporeal membrane oxygenation for more than 48 hours at a university hospital from 1996 to 2007 for respiratory (20.4%) and cardiac (79.6%) support. Results: During a total of 2559 extracorporeal membrane oxygenation days, 55 episodes of infections occurred in 45 patients (13.5%), including 38 bloodstream (14.85 per 1000 extracorporeal membrane oxygenation days), 6 surgical site, 4 respiratory tract, 3 urinary tract, and 4 other infections. Stenotrophomonas maltophilia (16.7%) and Candida species (14.6%) were the predominant blood isolates. In stepwise logistic regression analysis, longer duration of extracorporeal membrane oxygenation use (odds ratio 1.003; 95% confidence interval, 1.001-1.005; P = .004), mechanical complications (odds ratio, 4.849; 95% confidence interval, 1.569-14.991; P = .006), autoimmune disease (odds ratio, 6.997; 95% confidence interval, 1.541-31.766; P = .012), and venovenous mode (odds ratio, 4.473; 95% confidence interval, 1.001-19.977; P = .050) were independently associated with a higher risk for infections during extracorporeal membrane oxygenation use. Overall in-hospital mortality was 68.3%, and its independent risk factors included older age (odds ratio, 1.037; 95% confidence interval, 1.021-1.054; P < .001), neurologic complications (odds ratio, 51.153; 95% confidence interval, 6.773-386.329; P < .001), and vascular complications (odds ratio, 1.922; 95% confidence interval, 1.112-3.320; P < .001), but not infections during extracorporeal membrane oxygenation use. Conclusions: Bloodstream infection was the most common infection during extracorporeal membrane oxygenation use. Duration of extracorporeal membrane oxygenation, mechanical complications, autoimmune disease, and venovenous mode seemed to be independently associated with infections. ? 2010 by The American Association for Thoracic Surgery. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77957984402&doi=10.1016%2fj.jtcvs.2010.07.017&partnerID=40&md5=8d3faae426712420ad0a3cf262b980b0 https://scholars.lib.ntu.edu.tw/handle/123456789/589253 |
ISSN: | 0022-5223 | DOI: | 10.1016/j.jtcvs.2010.07.017 | SDG/關鍵字: | adolescent; adult; aged; article; assisted ventilation; autoimmune disease; bacterium isolate; bloodstream infection; Candida; catheter infection; disease association; extracorporeal oxygenation; female; hospital infection; human; independent variable; infection risk; major clinical study; male; mortality; neurological complication; priority journal; Pseudomonas aeruginosa; respiratory tract infection; retrospective study; risk factor; senescence; skin infection; soft tissue infection; Staphylococcus aureus; Stenotrophomonas maltophilia; surgical infection; university hospital; urinary tract infection; vascular disease; antibiotic prophylaxis; Bacterial Infections; cross infection; extracorporeal oxygenation; microbiology; middle aged; Mycoses; risk; risk assessment; statistical model; Taiwan; time; young adult; Adolescent; Adult; Aged; Antibiotic Prophylaxis; Bacterial Infections; Cross Infection; Extracorporeal Membrane Oxygenation; Female; Hospital Mortality; Hospitals, University; Humans; Logistic Models; Male; Middle Aged; Mycoses; Odds Ratio; Retrospective Studies; Risk Assessment; Risk Factors; Taiwan; Time Factors; Young Adult |
顯示於: | 醫學系 |
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