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Infections in Children Receiving Extracorporeal Life Support

Published online by Cambridge University Press:  02 January 2015

Alena Tse-Chang ,
William Midodzi ,
Ari R. Joffe  and
Joan L. Robinson
Alena Tse-Chang
Affiliation:
Department of Pediatrics and Stollery Children's Hospital, Edmonton, Alberta, Canada
William Midodzi
Affiliation:
Epidemiology Coordinating and Research Centre, Edmonton, Alberta, Canada
Ari R. Joffe
Affiliation:
Department of Pediatrics and Stollery Children's Hospital, Edmonton, Alberta, Canada
Joan L. Robinson*
Affiliation:
Department of Pediatrics and Stollery Children's Hospital, Edmonton, Alberta, Canada
*
Room 8213, Aberhart Centre One, 11402 University Avenue, Edmonton, AB CanadaT6G 2J3 (jr3@ualberta.ca)
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Abstract

Objective.

To describe risk factors for and the outcome of infections in children receiving extracorporeal life support (ECLS) and to determine the need for removal of foreign bodies with bloodstream infections (BSIs) in children receiving ECLS.

Design.

Retrospective cohort study.

Setting.

Tertiary care children's hospital.

Patients.

Children receiving ECLS from May 1997 through May 2007.

Methods.

For patients with documented infections, medical records were examined for demographic, clinical, and laboratory details. Patients with and without documented infections were compared with regard to demographic characteristics and ECLS course.

Results.

One hundred seventeen patients underwent ECLS for a total of 878 days (median, 5.12 days). Thirty-five patients (29.9%) developed 55 infections, including 21 BSIs (38.2%), 20 urinary tract infections (36.4%), 6 ventilator-associated pneumonia episodes (10.9%), 2 viral infections (3.6%), and 6 miscellaneous infections (10.9%). The rates (in cases per 1,000 ECLS-days) were 23.9 for BSI, 22.8 for urinary tract infection, and 6.8 for ventilator-associated pneumonia. There were no significant differences in the demographic characteristics, indications for ECLS, or ECLS course between infected and uninfected patients, except for the median duration of ECLS (10.1 vs 3.8 days; P < .001). One death was attributed to infection. Resolution of BSI occurred without removal of foreign bodies in 18 (85.7%) of 21 children.

Conclusions.

Longer duration of ECLS was the only identified risk factor for infection. Mortality was not statistically significantly different between infected and uninfected patients. Most BSIs that occurred during ECLS cleared without removal of foreign bodies.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 2 , February 2011 , pp. 115 - 120
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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