Evidence map›Paper›PMID 41504890›Full record

ArticleIntensive care medicine2026

A consensus of international experts on definition, sampling, treatment, and prevention of peripheral extracorporeal membrane oxygenation cannula-site infection obtained by the Delphi method: the SAVECMO study.

Paul Masi, Darryl Abrams, Ali Ait Hssain, Martin Balik, Nicholas A Barrett, Lars Mikael Broman, Luigi Camporota, Yih-Sharng Chen, Alain Combes, Daniel De Backer and 32 more

Abstract readConsensus Statement
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In one paragraph

Article in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Paul MasiService de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.
Darryl AbramsDivision of Pulmonary, Allergy, and Critical Care, Columbia University College of Physicians and Surgeons, New York, USA.
Ali Ait HssainMedical Intensive Care Unit, Hamad General Hospital, Department of Medicine, Weill Cornell Medical College Doha, College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar.
Martin BalikFaculty of Medicine, Department of Anesthesiology and Intensive Care, Charles University, Prague, Czechia.
Nicholas A BarrettDepartment of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Lars Mikael BromanECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
Luigi CamporotaDepartment of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Yih-Sharng ChenDivision of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Alain CombesService de Médecine Intensive Réanimation, Institut de Cardiologie, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France.
Daniel De BackerDepartment of Intensive Care Medicine, CHIREC Hospitals, Université Libre de Bruxelles, Brussels, Belgium.
Lorenzo Del SorboInterdepartmental Division of Critical Care Medicine Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.
Rodrigo DiazECMO Unit, Departamento de Anestesia, Clínica Las Condes, Las Condes, Santiago, Chile.
Dirk W DonkerIntensive Care Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Ghislaine DoufléDepartment of Anesthesia and Pain Management, University Health Network, Toronto General Hospital, Toronto, Canada.
Eddy FanInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
John F FraserCritical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.
Marco GianiDepartment of Medicine and Surgery, Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy.
Raphael GiraudIntensive Care Division, Department of Acute Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
Giacomo GrasselliDepartment of Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Sami HraiechService de Médecine Intensive Réanimation, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Roberto LorussoHeart and Vascular Centre, Maastricht University, Maastricht, The Netherlands.
Graeme MacLarenCardiothoracic Intensive Care Unit, National University Hospital, Singapore, Singapore.
Joseph E MarcusInfectious Diseases Service, Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA.
Gennaro MartucciDepartment of Anesthesia and Intensive Care, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS ISMETT), Palermo, Italy.
Pedro Vitale MendesIntensive Care Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Shinichiro OhshimoDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
José-Artur PaivaIntensive Care Medicine Service, Unidade Local de Saúde São João, Alameda Professor Hernani Monteiro, Porto, Portugal.
Sunghoon ParkIntensive Care Unit, Hallym University Sacred Heart Hospital, Anyang, South Korea.
Kollengode RamanathanCardiothoracic Intensive Care Unit, National University Heart Centre, National University Health System, Singapore, Singapore.
Jordi RieraCritical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Roberto Roncon-AlbuquerqueDepartment of Intensive Care Medicine, São João University Hospital, Porto, Portugal.
Leonardo SalazarServicio ECMO, Fundación Cardiovascular de Colombia, Bucaramanga, Colombia.
Matthieu SchmidtService de Médecine Intensive Réanimation, Institut de Cardiologie, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France.
Aditya ShahDivision of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, USA.
Kiran ShekarAdult Intensive Care Services, The Prince Charles Hospital, Brisbane, Australia.
Alexander SupadyInterdisciplinary Medical Intensive Care, University Medical Center-University of Freiburg, Freiburg, Germany.
Fabio Silvio TacconeDepartment of Intensive Care, Hôpital Universitaire de Bruxelles (HUB)Université Libre de Bruxelles (ULB), Brussels, Belgium.
Joseph E TonnaDivision of Cardiothoracic Surgery, Department of Surgery, University of Utah Health, Salt Lake City, USA.
Pauline Yeung NgCritical Care Medicine Unit, The University of Hong Kong, Hong Kong, China.
Hakeem YusuffUniversity Hospitals of Leicester National Health Service Trust, Glenfield Hospital Extracorporeal Membrane Oxygenation Unit, Leicester, UK.
Charles-Edouard LuytService de Médecine Intensive Réanimation, Institut de Cardiologie, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France. charles-edouard.luyt@aphp.fr.ORCID 0000-0001-7424-2705
For EuroELSO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNosocomial infections are common in patients receiving extracorporeal membrane oxygenation (ECMO), with ECMO cannula-site infections (ECMO-CSI) being the most frequent infections directly related to the ECMO run. These infections can significantly impact patient outcomes. Currently, no adult guidelines exist for the prevention, diagnosis, and/or treatment of peripheral ECMO-CSI, resulting in heterogeneity in both clinical practice and research findings.

methodsWe conducted a Delphi study involving 39 international experts in ECMO management. The experts participated in four Delphi rounds to reach consensus on various aspects of ECMO-CSI complicating peripheral ECMO (central ECMO excluded), including definition, clinical suspicion, diagnostic methods, preventive measures, and treatment. Consensus was defined as ≥ 70% agreement among experts on each proposed item.

resultsThe Delphi process established consensus on key aspects of ECMO-CSI. Experts agreed on clinical scenarios that warrant suspicion of ECMO-CSI, such as purulent discharge and local inflammatory signs. Standardized sampling techniques, including swabs and purulent drainage aspiration, were recommended, while others were rejected. Definitions were clarified, specifying that ECMO-CSI is defined by the isolation of a pathogen through local microbiological sampling and the presence of purulent discharge or local inflammatory signs. Among the preventive measures, the use of chlorhexidine-impregnated or semipermeable polyurethane dressings, unchanged for 7 days unless soiled or bleeding, was recommended, whereas systematic antibiotic prophylaxis, even for surgical ECMO, was not recommended.

conclusionThis study presents an international expert consensus focusing on peripheral ECMO-CSI, providing a standardized framework to improve clinical management and facilitate future research. The consensus aims to enhance patient outcomes and support evidence-based guidelines in this complex field.

Indexed as

CannulaCatheter-Related InfectionsCross InfectionExtracorporeal Membrane OxygenationDelphi TechniqueHumansCannula-site infection (CSI)DefinitionDelphiExtracorporeal membrane oxygenation (ECMO)PreventionTreatment

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.