Zhao Zhiwen, Liang Pengfei, Cai Lanlan, Zhang Li, Jia Qi, Tao Wentao, Fang Zhicheng
Department of Emergency Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
Front Microbiol. 2025 Mar 4;16:1555701. doi: 10.3389/fmicb.2025.1555701. eCollection 2025.
Extracorporeal membrane pulmonary oxygenation (ECMO) is the last barrier to save lives and is widely used in the treatment of critical respiratory and circulatory diseases, but infection is one of its common complications. The aim of this study was to analyse the clinical characteristics, survival rates and prognostic factors of patients with ECMO-related nosocomial infections.
This study retrospectively analysed patients treated with ECMO at a tertiary hospital in China between 2017 and 2023. Patient demographic data, ECMO indications, type of pathogen and site of infection, duration of ECMO and tracheal intubation-assisted breathing, and indicators of inflammation at the time of first infection were collected. Patients were divided into surviving and non-surviving groups based on survival, and differences in early inflammatory markers between the two groups were compared.
A total of 186 patients were treated with ECMO between 2017 and 2023, of whom 61 (32.7%) developed nosocomial infections and 5 declined to participate in the study. In the surviving group after infection, 21 patients (37.5%) had a mean age of 51 years; in the non-surviving group, 35 patients (62.5%) had a mean age of 54 years. The most common site of infection was the respiratory tract (75%), followed by haematogenous infections; the predominant pathogenic organisms were (46.43%) and (35.71%). IL-6, hs-CRP, and Plt differed significantly between the two groups ( < 0.05) [IL-6 (40.62 vs. 196.75 μg/mL, < 0.001), hs-CRP (8.86 vs. 23.60 mg/L, p < 0.001), and Plt (85.00 vs. 48.50 × 10, = 0.02)], but there were no significant differences in PCT, WBC, and NE. One-way logistic regression analysis showed that IL-6 (OR: 1.02, 95% CI: 1.01-1.03; = 0.001), hs-CRP (OR: 1.59, 95% CI: 1.02-2.47; = 0.041), and Plt (OR: 1.01, 95% CI: 1.01-1.02; = 0.031) were important factors affecting the prognosis of ECMO-related nosocomial infections.
Respiratory tract infections were the most common during ECMO treatment, and the main pathogen was . Early inflammatory markers such as elevated IL-6, hs-CRP and reduced platelet count may be risk factors for poor prognosis and have significance in guiding prognostic assessment.
体外膜肺氧合（ECMO）是挽救生命的最后一道防线，广泛应用于治疗严重的呼吸和循环系统疾病，但感染是其常见并发症之一。本研究旨在分析ECMO相关医院感染患者的临床特征、生存率及预后因素。
本研究回顾性分析了2017年至2023年在中国一家三级医院接受ECMO治疗的患者。收集患者的人口统计学数据、ECMO适应症、病原体类型和感染部位、ECMO及气管插管辅助呼吸的持续时间，以及首次感染时的炎症指标。根据生存情况将患者分为存活组和非存活组，比较两组早期炎症标志物的差异。
2017年至2023年共有186例患者接受了ECMO治疗，其中61例（32.7%）发生医院感染，5例拒绝参与本研究。感染后存活组中，21例患者（37.5%）平均年龄为51岁；非存活组中，35例患者（62.5%）平均年龄为54岁。最常见的感染部位是呼吸道（75%），其次是血行感染；主要致病微生物为（46.43%）和（35.71%）。两组间IL-6、hs-CRP和Plt差异有统计学意义（<0.05）[IL-6（40.62 vs. 196.75μg/mL，<0.001），hs-CRP（8.86 vs. 23.60mg/L，p<0.001），Plt（85.00 vs. 48.50×10，=0.02）]，但PCT、WBC和NE无显著差异。单因素Logistic回归分析显示，IL-6（OR：1.02，95%CI：1.01-1.03；=0.001）、hs-CRP（OR：1.59，95%CI：1.02-2.47；=0.041）和Plt（OR：1.01，95%CI：1.01-1.02；=0.031）是影响ECMO相关医院感染预后的重要因素。
ECMO治疗期间呼吸道感染最为常见，主要病原体为。IL-6升高、hs-CRP升高及血小板计数降低等早期炎症标志物可能是预后不良的危险因素，对指导预后评估具有重要意义。
