Prevalence and prognostic relevance of invasive fungal disease during veno-arterial extracorporeal membrane oxygenation (ECMO): A retrospective single-center study
Authors' conclusion
IFD are detected in about one in 20 patients on V-A ECMO, indicating mortality >90%. However, IFD do not contribute to prognosis in this population.
Study context
- Population
- Adults on veno-arterial ECMO at a German University Hospital, January 2013 to November 2023421 received veno-arterial (V-A) ECMO
- Participants
- 392 adults
- Exposure
- Invasive fungal disease (IFD) vs non-IFD
- IFDn = 18
- non-IFDn = 374reference
- Outcome
- Prevalence of invasive fungal disease
Methodological detailssingle-centre, multivariable logistic regression, propensity-score matched
- Single-centre
- Multivariable logistic regression
- Propensity-score matched
Main finding
As reported in the abstract
Prevalence of IFD, invasive candidiasis and probable invasive pulmonary aspergillosis
Prevalence of IFD
4.6%
Prevalence of invasive candidiasis
3.8%
Prevalence of probable invasive pulmonary aspergillosis
1.0%
Observational data: associations, not effects.
Further findings
In-hospital mortality
P = 0.0156
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| In-hospital mortality | 8.31 (1.60–153.18) | p: 0.044 | |
| 0.050.21520Odds ratio (log scale) |
- In-hospital mortality: multivariable; other predictors female sex, SOFA score at admission, SAVE score
Predictors of IFD
- Severity of acute disease, pre-existing moderate-to-severe renal disease and continuous kidney replacement therapy predictive of IFD
Outcome after propensity-score matching
- No difference in outcome after matching IFD-cases to non-IFD-controls
- Matched cohort
Original publication
Prevalence and prognostic relevance of invasive fungal disease during veno-arterial ECMO: A retrospective single-center study. J Crit Care. Published 25 May 2024. doi:10.
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