The following is a summary of “Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis,” published in the May 2024 issue of Critical Care by Hssain et al.

The growing use of extracorporeal membrane oxygenation (ECMO) for life support is linked to a higher incidence of nosocomial infections (NIs).

Researchers conducted a retrospective study investigating the occurrence and factors influencing NIs in adults undergoing ECMO therapy.

They searched PubMed, Scopus, Web of Science, and ProQuest databases (2022). The main focus was on the frequency of NI. Other points of interest included the duration of ECMO, length of stay in intensive care and hospital (LOS), ECMO survival, and OS; NI frequency was expressed as pooled proportions with 95% CIs. Dichotomous results were presented as RR with 95% CIs, utilizing a random-effects model.

The results showed 4,733 adult patients who underwent ECMO support in the 30 studies, 1,249 were  ECMO-related NIs per 1000 ECMO-days. The combined NI incidence from 18 studies involving 3,424 patients was 26% (95% CI 14–38%). Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the primary sources of NI. Infected patients exhibited lower ECMO survival and OS rates compared to non-infected patients, with RR of 0.84 (95% CI 0.74–0.96, P=0.01) and 0.80 (95% CI 0.71–0.90, P<0.001), respectively.

Investigators concluded that adult patients on ECMO with NIs experienced a significant decrease in both ECMO and OS  rates compared to those without NIs.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04946-8