Clinical Report: Viral ARDS and Pathogen Trends in Patients on V-V ECMO
Overview
This study characterizes the prevalence and microbiological spectrum of superinfections in patients with viral ARDS requiring V-V ECMO.
Background
Viral respiratory infections, particularly COVID-19, have led to significant morbidity and mortality, necessitating advanced interventions like V-V ECMO. Patients on mechanical ventilation are at increased risk for bacterial superinfections, which complicate their management. Understanding the microbiological trends in these patients is crucial.
Data Highlights
No numerical data available in the source material.
Key Findings
VAP incidence in COVID-19 patients on V-V ECMO can be as high as 86%.
70% of VAP cases are caused by Enterobacteriaceae, with 57% being ESBL producers.
COVID-19 associated pulmonary Aspergillosis (CAPA) occurs in up to 27.7% of cases.
Herpes simplex virus (HSV) reactivation is reported in 31% of patients, while cytomegalovirus (CMV) reactivation occurs in 9-15%.
Microbiological testing for influenza patients is less frequent compared to COVID-19 patients.
Clinical Implications
The high rates of bacterial superinfection and viral reactivation in patients with viral ARDS on V-V ECMO necessitate vigilant monitoring and microbiological testing. Clinicians should be aware of the predominant pathogens and adjust treatment protocols accordingly.
Conclusion
This study provides insights into the microbiological challenges faced by patients with viral ARDS on V-V ECMO.
by Jannis Krais, Matthias Lubnow, Alois Philipp, Maik Foltan, Florian Geismann, Christoph Fisser, Florian Hitzenbichler, Bernd Salzberger, Stilla Bauernfeind, Barbara Schmid, Dirk Lunz, Johannes Steinmann, Christoph Eissnert, Martin Kieninger, Walter Petermichl, Roland Schneckenpointner, Alexander Dietl, Lars S. Maier, Bernhard Graf, Thomas Müller, Clemens Wiest
A global systematic review of 173 studies found differing associations between COVID-19 infection and vaccination and retinal vascular events, with retinal artery occlusion more common after infection and retinal vein occlusion more common after vaccination.
