Retrospective ANalysis of multi-drug resistant Gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY
An erratum to this article was published (Crit Care, 13 Feb 2025 ↗)
Authors' conclusion
21% of MDR GN bacteria were detected before; while 29% after V-V ECMO connection. A history of MDR GN bacteria, isolated before V-V ECMO, was an independent risk factor for mortality. The annual hospital V-V ECMO volume affected the probability of acquiring MDR GN bacteria.
Study context
- Population
- Adults requiring V–V ECMO in ICUs of 5 Italian university-affiliated hospitals72% male
- Participants
- 279 adults
- Exposure
- Predetected multi-drug resistant (MDR) Gram-negative (GN) bacteria and V-V ECMO-acquired MDR GN bacteria vs non-MDR GN bacteria
- Predetectedn = 59
- V-V ECMO-acquired MDR GN bacterian = 80
- Outcome
- Prevalence and incidence of MDR Gram-negative bacteria; risk of 1-year mortality
- Follow-up
- 1 year
Methodological detailsmulticentre, consecutive patients, Cox proportional hazards models for mortality, Standard microbiological surveillance protocol; MDR profiles by in vitro susceptibility tests
- Multicentre
- Consecutive patients
- Cox proportional hazards models for mortality
- Standard microbiological surveillance protocol; MDR profiles by in vitro susceptibility tests
Main finding
As reported in the abstract
MDR GN bacteria and 1-year mortality
Each group vs non-MDR GN bacteriaAdjusted hazard ratio (CI)P value
Predetected
2.14(1.33–3.47)
p value 0.002V-V ECMO-acquired MDR GN bacteria
1.51(0.94–2.42)
p value 0.090- Overall MDR GN bacteria percentage
- 50%
- Overall 1-year mortality
- 42%
Observational data: associations, not effects.
Further findings
Acquiring MDR GN bacteria during V-V ECMO by annual hospital V-V ECMO volume
| aOR (CI) | P value | ||
|---|---|---|---|
| Larger annual hospital V-V ECMO volume | 0.91 (0.86–0.97) | p value 0.002 | |
| 0.512Adjusted odds ratio (log scale) |
1-year mortality, infections only
- Same findings were found considering only infections
Original publication
Retrospective ANalysis of multi-drug resistant Gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY. Crit Care. Published 27 August 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →