Abstract：
Patients with prolonged duration of extracorporeal membrane oxygenation support (ECMO) are a vulnerable population for sepsis, particularly ventilator-associated pneumonia and bloodstream infections. Rates differ between venous-arterial and venous-venous ECMO patients and according to the cannulation technique used. The presence of particular organisms depends on local epidemiology, antibiotic exposure, and the duration of the intervention; patients undergoing ECMO for more than three weeks present a high risk of persistent candidemia. Recognizing predisposing factors, and establishing the best preventive interventions and therapeutic choices are critical to optimizing the management of these complications. Infection control practices, including shortening the period of the indwelling devices, and reducing antibiotic exposure, must be followed meticulously. Innovations in oxygenator membranes require an updated approach. Hand hygiene and avoiding breaking the circuit-oxygenator sterility are cornerstones. ECMO management would benefit from clearer definitions, optimization of infection control strategies, and updated infectious clinical practice guidelines.
摘要：
长期使用体外膜氧合支持（ECMO）的患者是败血症的脆弱人群，尤其是呼吸机相关性肺炎和血流感染。根据所使用的插管技术，静脉-动脉和静脉-静脉ECMO患者的比率有所不同。特定生物的存在取决于当地的流行病学，抗生素暴露,和干预持续时间;接受ECMO超过三周的患者存在持续性念珠菌菌血症的高风险。认识到诱发因素，建立最佳的预防性干预措施和治疗选择对于优化这些并发症的管理至关重要.感染控制实践，包括缩短留置装置的时间，减少抗生素暴露，必须一丝不苟地遵循。氧合器膜的创新需要更新的方法。手部卫生和避免破坏电路-氧合器无菌是基石。ECMO管理将受益于更清晰的定义，优化感染控制策略，并更新了感染性临床实践指南。
