Prevalence and Microbiological Profile of Septic Complications Following ECMO Decannulation - A Prospective Single-Center Study
Extracorporeal membrane oxygenation (ECMO) is widely used to manage acute respiratory distress syndrome (ARDS), but biofilm formation on cannulas may contribute to infections. This study investigated the prevalence, timing, and microbial profiles of infectious complications following ECMO decannulation.This prospective, single-center cohort study was conducted in the mixed medical-surgical intensive care unit (ICU) at University Hospital Essen (01.2022-01.2023). Adults receiving ECMO for more than 48 hours were included. Microbiological sampling (blood cultures, wound swabs) was performed before and after decannulation. Cannulas were assessed for biofilms, and plasma samples were analyzed by next-generation sequencing (NGS) on microbial cell-free DNA (cfDNA). Sepsis was defined according to the most recent Sepsis-3 criteria.Sepsis and infection are frequent after ECMO decannulation and may be linked to biofilm-related pathogens. NGS improved pathogen detection beyond standard diagnostics, supporting the need for advanced, integrated microbiological surveillance post-ECMO.