Community versus hospital-acquired pneumonia in patients requiring extracorporeal membrane oxygenation
| Autor: | Yang Hyun Cho, Kyeongman Jeon, Gee Young Suh, Soo Jin Na, Chul Keun Park, Chi Ryang Chung |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty ARDS Organ Dysfunction Scores medicine.medical_treatment Acute respiratory distress Hospital-acquired pneumonia 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Drug Resistance Multiple Bacterial medicine Extracorporeal membrane oxygenation Pneumonia Bacterial pneumonia Humans Pharmacology (medical) In patient 030212 general & internal medicine Original Research Aged Retrospective Studies lcsh:RC705-779 Respiratory Distress Syndrome business.industry Bacterial pneumonia Healthcare-Associated Pneumonia lcsh:Diseases of the respiratory system acute respiratory distress syndrome Middle Aged medicine.disease Community-Acquired Infections Survival Rate Pneumonia 030228 respiratory system Emergency medicine Female business |
| Zdroj: | Therapeutic Advances in Respiratory Disease Therapeutic Advances in Respiratory Disease, Vol 13 (2019) |
| ISSN: | 1753-4666 |
| Popis: | Background: Bacterial pneumonia is a major cause of acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) support. However, it is unknown whether the type of pneumonia, community-acquired pneumonia (CAP) versus hospital-acquired pneumonia (HAP), should be considered when predicting outcomes for ARDS patients treated with ECMO. Methods: We divided a sample of adult patients receiving ECMO for acute respiratory distress syndrome caused by bacterial pneumonia between January 2012 and December 2016 into CAP ( n = 21) and HAP ( n = 35) groups and compared clinical and bacteriological characteristics and outcomes. Results: The median acute physiology and chronic health evaluation II and sequential organ failure assessment scores were 22 and 8, respectively, in the CAP and HAP groups. The most commonly identified organism in the CAP group was Streptococcus pneumonia ( n = 12, 57.1%), while Acinectobacter baumanii was the most commonly identified in the HAP group ( n = 13, 37.1%). However, the incidence of multidrug resistant bacteria was not different between groups (57.1% versus 74.3%, p = 0.125). Of the 56 patients in the study, 26 were successfully weaned from ECMO, and 20 were discharged from the hospital. There were no significant differences in ECMO weaning rate (47.6% versus 45.7%, p > 0.999) or survival to discharge rate (33.3% versus 37.1%, p > 0.999) between the two groups. The 30-day and 90-day mortality rates were also similar. Conclusion: Patients with CAP and HAP who received ECMO for respiratory support had similar characteristics and clinical outcomes. |
| Databáze: | OpenAIRE |
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