Abstract:
Over the past 10 years, there has been a rapid expansion in the use of extracorporeal membrane oxygenation (ECMO) in the care of patients with refractory cardiac or respiratory failure. Infectious diseases clinicians must reconcile conflicting evidence from limited studies as they develop practices at their own institutions, which has resulted in considerably different practices globally. This review describes infection control and prevention as well as antimicrobial prophylaxis strategies in this population. Data on diagnostics and treatment for patients receiving ECMO with a focus on diagnostic and antimicrobial stewardship is then examined. This review summarizes gaps in the current ECMO literature and proposes future needs, including developing clear definitions for infections and encouraging transparent reporting of practices at individual facilities in future clinical trials.
摘要:
在过去的十年里,体外膜氧合(ECMO)在难治性心力衰竭或呼吸衰竭患者治疗中的应用迅速扩大.传染病临床医生必须调和来自有限研究的相互矛盾的证据,因为他们在自己的机构发展实践,这导致了全球截然不同的做法。这篇综述描述了该人群的感染控制和预防以及抗菌预防策略。然后检查接受ECMO的患者的诊断和治疗数据,重点是诊断和抗菌药物管理。这篇综述总结了当前ECMO文献中的差距,并提出了未来的需求,包括为感染制定明确的定义,并鼓励在未来的临床试验中对各个机构的实践进行透明的报告。