ArticleCritical care (London, England)2018
Fungal infections in adult patients on extracorporeal life support.
Article in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Prevalence of invasive fungal infection in critically Ill patients: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Time-varying voriconazole clearance during extracorporeal membrane oxygenation.Antimicrobial agents and chemotherapy · 2026Observational
- The looming threat of invasive fungal infections in heart transplant recipients: Will it be the last of us.JHLT open · 2026Review
- Invasive Fungal Infections During Extracorporeal Membrane Oxygenation: A Case Series from Intensive Care Unit and Literature Review.Diagnostics (Basel, Switzerland) · 2026Article
- Population pharmacokinetics of caspofungin in critically ill Chinese children: a prospective observational study.Antimicrobial agents and chemotherapy · 2026Observational
- Case Report: Prolonged extracorporeal membrane oxygenation as a deliberate operative adjunct for tracheobronchial reconstruction in a child with invasive aspergillosis.Frontiers in pediatrics · 2026Article
- Low isavuconazole trough levels in critically ill patients with and without extracorporeal membrane oxygenation.Antimicrobial agents and chemotherapy · 2025Article
- Retrospective Analysis of Fungal Isolations in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: The Multicenter RANGER STUDY 2.0.Journal of fungi (Basel, Switzerland) · 2025Article
- Population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation-an ASAP ECMO study.Antimicrobial agents and chemotherapy · 2025Article
- Invasive fungal infections during extracorporeal membrane oxygenation.Intensive care medicine · 2025Article
- Clinical Characteristics, Prognosis, and Risk Factors for Mortality in Influenza-Associated Pulmonary Aspergillosis and COVID-19-Associated Pulmonary Aspergillosis: A Multicenter Retrospective Study.Infection and drug resistance · 2025Article
- Antifungals in Patients With Extracorporeal Membrane Oxygenation: Clinical Implications.Open forum infectious diseases · 2024Review
- Venoarterial extracorporeal membrane oxygenation in immunocompromised patients with cardiogenic shock: a cohort study and propensity-weighted analysis.Intensive care medicine · 2024Article
- Population pharmacokinetics of fluconazole in critically ill patients receiving extracorporeal membrane oxygenation and continuous renal replacement therapy: an ASAP ECMO study.Antimicrobial agents and chemotherapy · 2024Article
- Analysis of 24-hour Death Risk Factors in Circulatory Failure Patients Treated with Venoarterial Extracorporeal Membrane Oxygenation.Brazilian journal of cardiovascular surgery · 2023Article
- COVID-19 Is an Independent Risk Factor for Detrimental Invasive Fungal Disease in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: A Retrospective Study.Journal of fungi (Basel, Switzerland) · 2023Article
- Antifungal Dosing in Critically Ill Patients on Extracorporeal Membrane Oxygenation.Clinical pharmacokinetics · 2023Review
- The Influence of Extracorporeal Membrane Oxygenation on Antibiotic Pharmacokinetics.Antibiotics (Basel, Switzerland) · 2023Review
- Clinical and microbiological characteristics of and risk factors for bloodstream infections among patients with extracorporeal membrane oxygenation: a single-center retrospective cohort study.Scientific reports · 2022Article
- Outcomes of Fungemia in Patients Receiving Extracorporeal Membrane Oxygenation.Open forum infectious diseases · 2022Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients on extracorporeal membrane oxygenation (ECMO) are often among the most severely ill in the intensive care unit. They are often receiving broad-spectrum antibiotics; they have multiple entry points for pathogens; and their immune system is impaired by blood circuit interaction. These factors are thought to predispose them to fungal infections. We thus aimed to evaluate the prevalence, risk factors, and prognosis of fungal infections in adults on ECMO.
methodsWe conducted a retrospective cohort study using the Extracorporeal Life Support Organization registry, which compiles data on ECMO use from hundreds of international centers. We included all adult patients from 2006 to 2016 on any mode of ECMO with either a diagnosis of fungal infection or a positive fungal culture.
resultsOur study comprised 2129 adult patients (10.8%) with fungal colonization or infection. Aspergillus involvement (colonization or infection) was present in 272 patients (1.4%), of whom 35.7% survived to hospital discharge. There were 245 patients (1.2%) with Candida invasive bloodstream infection, with 35.9% survival. Risk factors for Aspergillus involvement included solid organ transplant (OR 1.83; p = 0.008), respiratory support (OR 2.75; p < 0.001), and influenza infection (OR 2.48; p < 0.001). Risk factors for candidemia included sepsis (OR 1.60; p = 0.005) and renal replacement therapy (OR 1.55; p = 0.007). In multivariable analysis, Aspergillus involvement (OR 0.40; p < 0.001) and candidemia (OR 0.47; p < 0.001) were both independently associated with decreased survival.
conclusionsThe prevalence of Aspergillus involvement and Candida invasive bloodstream infection were not higher in patients on ECMO than what has been reported in the general intensive care population. Both were independently associated with a reduced survival. Aspergillus involvement was strongly associated with ECMO for respiratory support and influenza.
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