2095. Infections in Burn Patients Receiving Extracorporeal Membrane Oxygenation (ECMO) at a Tertiary Military Medical Center

Abstract

BackgroundPatients on ECMO are at higher risk for nosocomial infections. While several studies report on infections in ECMO patients, the epidemiology of infections in burn patients on ECMO has not been previously described.MethodsA retrospective chart review was performed on all patients on ECMO for >48 hours at Brooke Army Medical Center and the U.S. Army Institute of Surgical Research Burn Center between 2012 and 2017. Patient demographics, burn status, ECMO characteristics, and infection incidence during ECMO were captured. Statistical analyses comparing burn vs. nonburn patients were performed using chi-squared, Fisher’s exact and Mann–Whitney U tests.ResultsIn comparison with those without diagnosed infections, infected patients had more days on ECMO (median [IQR] 16 [12–20] vs. 6.5 [5–10], P < 0.01) and longer hospitalization (median [IQR] 35 [24–54] vs. 23.5 days [8–45], P = 0.06), however survival to hospital discharge was no different (64% vs. 58%, P = 0.77). Burn patients trended toward more infections in their ECMO course (table).Burn (n = 14)Nonburn (n = 38) P-ValueMedian age (years)29.5 (25–39)39 (29.5–55.5)0.05Gender, male9 (64%)25 (74%)1Median days on ECMO14 (8–18)9 (5–14)0.26Survival to discharge9 (64%)23 (72%)1Median length of stay (days)34 (25–47)24 (11–50)0.23Median burn % total body surface area (%TBSA)25 (21–40)n/an/aInfections on ECMOAny infection10 (71%)18 (47%)0.21 Multiple infections7 (50%)9 (24%)0.07Respiratory infection (RI)9 (64%)13 (34%)0.07Blood stream infection (BSI)4 (28.6%)7 (18.4%)0.46Other infection5 (35.7%)9 (24%)0.49Median time to RI diagnosis (days)3 (1–9)2 (1–6.5)0.79Median time to BSI diagnosis (days)2.5 (2–5)5 (1–2)0.74Total infections per 1000 ECMO days99.750.60.02RI per 1,000 ECMO days49.922.70.12BSI per 1,000 ECMO days22.112.20.52All data expressed as number N, % or median, interquartile range (IQR) unless otherwise stated.ConclusionInfection is a common complication of ECMO and is associated with longer duration on ECMO and longer hospitalizations. Burn patients in this cohort were observed to have higher rates of infection compared with nonburn patients.Disclosures All authors: No reported disclosures.