title: Influence of different oxygenator types on changing frequency, infection incidence, and mortality in ARDS patients on veno-venous ECMO.
abstract: OBJECTIVE
  Veno-venous extracorporeal membrane oxygenation (vv-ECMO) is pivotal in the treatment of patients suffering from acute respiratory distress syndrome (ARDS). Comparative data with different oxygenator models have not yet been reported. The aim of this retrospective investigation was therefore to assess whether different oxygenator types might influence changing frequency, infection incidence, and mortality in patients on vv-ECMO.
  
  
  METHODS
  42 patients undergoing vv-ECMO between 1998 and 2009 were identified. In 20 out of these patients, a polypropylene (PP) microporous hollow fiber membrane oxygenator, and in 22 patients a nonmicroporous polymethylpentene (PMP) diffusion membrane oxygenator was used. Infection incidence, changing frequency, and mortality were documented.
  
  
  RESULTS
  In the PMP group, an oxygenator change was necessary less often than in the PP group (p<0.001). The incidence of bacterial, viral, or fungal growth was similar in the groups, thus independent of the frequency of oxygenator change. Irrespective of the groups, the occurrence of Candida sp. tended to correlate with death (p = 0.06). In general, there was a trend towards a higher infection incidence in the subgroup with pulmonary ARDS (p = 0.07). Moreover, infection incidence was associated with a longer ICU stay (p = 0.03) and longer ECMO therapy (p = 0.03). ICU mortality was lower in the PMP group than in the PP group, although not statistically significant (p = 0.10).
  
  
  CONCLUSIONS
  The PMP oxygenator membranes showed benefits with regards to changing frequency, but not infection incidence, length of ICU stay, and length of ECMO therapy. There was a trend towards a lower ICU mortality in patients with PMP oxygenators.
authors.affiliation: 1 Department of Internal Medicine I, Intensive Care Unit, Medical University of Vienna, Vienna - Austria.
authors.forename: Oliver
authors.initials: O
authors.lastname: Robak
authors.forename: Philipp K S
authors.initials: PK
authors.lastname: Lakatos
authors.forename: Andja
authors.initials: A
authors.lastname: Bojic
authors.forename: Alexander
authors.initials: A
authors.lastname: Hermann
authors.forename: Klaus-Felix
authors.initials: KF
authors.lastname: Laczika
authors.forename: Astrid
authors.initials: A
authors.lastname: Chiari
authors.forename: Jörg M
authors.initials: JM
authors.lastname: Hiesmayr
authors.forename: Thomas
authors.initials: T
authors.lastname: Staudinger
authors.forename: Gottfried J
authors.initials: GJ
authors.lastname: Locker
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D003141:Communicable Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D004866:Equipment Contamination; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D010107:Oxygenators, Membrane / Q000009:adverse effects; D011090:Polyenes; D011126:Polypropylenes; D016062:Porosity; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014777:Virus Diseases / Q000175:diagnosis / Q000401:mortality / Q000821:virology; D055815:Young Adult
chemical_list: D011090:Polyenes; D011126:Polypropylenes; C021245:poly(methylpentene)