A consensus of international experts on definition, sampling, treatment, and prevention of peripheral extracorporeal membrane oxygenation cannula-site infection obtained by the Delphi method: the SAVECMO study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Masi Paul, Abrams Darryl, Hssain Ali Ait, Balik Martin, Barrett Nicholas A, Broman Lars Mikael, Camporota Luigi, Chen Yih-Sharng, Combes Alain, De Backer Daniel, Del Sorbo Lorenzo, Diaz Rodrigo, Donker Dirk W, Douflé Ghislaine, Fan Eddy, Fraser John F, Giani Marco, Giraud Raphael, Grasselli Giacomo, Hraiech Sami, Lorusso Roberto, MacLaren Graeme, Marcus Joseph E, Martucci Gennaro, Mendes Pedro Vitale, Ohshimo Shinichiro, Paiva José-Artur, Park Sunghoon, Ramanathan Kollengode, Riera Jordi, Roncon-Albuquerque Roberto, Salazar Leonardo, Schmidt Matthieu, Shah Aditya, Shekar Kiran, Supady Alexander, Taccone Fabio Silvio, Tonna Joseph E, Yeung Ng Pauline, Yusuff Hakeem, Luyt Charles-Edouard, For EuroELSO
Аннотация
METHODS: We conducted a Delphi study involving 39 international experts in ECMO management. The experts participated in four Delphi rounds to reach consensus on various aspects of ECMO-CSI complicating peripheral ECMO (central ECMO excluded), including definition, clinical suspicion, diagnostic methods, preventive measures, and treatment. Consensus was defined as ≥ 70% agreement among experts on each proposed item.
RESULTS: The Delphi process established consensus on key aspects of ECMO-CSI. Experts agreed on clinical scenarios that warrant suspicion of ECMO-CSI, such as purulent discharge and local inflammatory signs. Standardized sampling techniques, including swabs and purulent drainage aspiration, were recommended, while others were rejected. Definitions were clarified, specifying that ECMO-CSI is defined by the isolation of a pathogen through local microbiological sampling and the presence of purulent discharge or local inflammatory signs. Among the preventive measures, the use of chlorhexidine-impregnated or semipermeable polyurethane dressings, unchanged for 7 days unless soiled or bleeding, was recommended, whereas systematic antibiotic prophylaxis, even for surgical ECMO, was not recommended.
CONCLUSION: This study presents an international expert consensus focusing on peripheral ECMO-CSI, providing a standardized framework to improve clinical management and facilitate future research. The consensus aims to enhance patient outcomes and support evidence-based guidelines in this complex field.