This single-centre retrospective study reports the dynamics of the incidence of candida bloodstream infection (CBSI) in 145 patients receiving venovenous extracorporeal membrane oxygenation (ECMO) for respiratory support between January 2014 and December 2018. The incidence rate and odds ratio (OR) of CBSI were calculated, stratified by week of ECMO exposure. Weekly incidence increased throughout the ECMO run, with an increasing trend in OR (P=0.005), and a window of continued risk after decannulation was observed. Of the 13 patients who developed CBSI, five (38%) received empirical micafungin treatment before positive culture due to clinical suspicion. There is a need for prospective studies aiming to improve ECMO diagnostic stewardship practices and discourage unnecessary antifungal prophylaxis or empiric management.
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http://dx.doi.org/10.1016/j.jhin.2021.09.014 | DOI Listing |
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address:
Extracorporeal membrane oxygenation (ECMO) is an advanced treatment for severe respiratory failure. Implantation of ECMO before invasive ventilation or extubation during ECMO has been reported and is becoming increasingly popular. Avoidance of sedation and invasive ventilation during ECMO (commonly referred to as "awake ECMO") may have potential advantages, including a lower rate of delirium, shorter mechanical ventilation time, and the possibility of undergoing early rehabilitation and/or physiotherapy.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Department of General Surgery, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, Queensland, Australia.
Extracorporeal membrane oxygenation (ECMO) has emerged as a salvage therapy in refractory respiratory failure. Within the literature, there is evidence to support the use of ECMO in severe thoracic trauma; however, there is minimal information on its applicability in mild to moderate thoracic trauma. This report describes a man in his 50s who suffered thoracic trauma following a motor vehicle accident, who, despite maximal medical therapy, experienced deterioration in respiratory function, requiring the commencement of veno-venous ECMO on day 5 post injury and subsequently achieved excellent functional recovery.
View Article and Find Full Text PDFPediatr Cardiol
January 2025
Arkansas Children's Hospital, Arkansas Children's Hospital, 1 Children's Way, Slot 512-3, Little Rock, AR, 72202, USA.
Patent ductus arteriosus (PDA) stenting is a vital intervention for neonates with ductal-dependent blood flow, offering an attractive alternative to surgical shunt placement. Despite its benefits, the procedure poses risks such as ductal spasm, branch pulmonary artery compromise, and pseudoaneurysm formation. This report presents two complex neonatal cases with distinct outcomes.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
January 2025
From the Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY.
Background: Extracorporeal membrane oxygenation (ECMO) has emerged as a critical intervention in the management of patients with trauma-induced cardiorespiratory failure. This study aims to compare outcomes in patients with severe thoracic injuries with and without venovenous extracorporeal membrane oxygenation (VV-ECMO).
Methods: We performed a retrospective cohort study on Trauma Quality Improvement Program (2017-2021) and included all patients with isolated blunt thoracic injuries with Abbreviated Injury Scale score of ≥4 who required intubation.
Cureus
December 2024
Trauma and Acute Care Surgery, Good Samaritan University Hospital, West Islip, USA.
High-energy blunt thoracic trauma is a highly morbid condition. When a pneumonectomy is required in such a setting, the mortality rate increases significantly. Here, we present a case of a motor vehicular crash (MVC) in which the patient suffered bilateral bronchial injuries requiring emergent thoracotomy, pneumonectomy, bronchial stenting, and initiation of venovenous extracorporeal membrane oxygenation (VV ECMO).
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