R. Murray et al.: J Extra Corpor Technol 2025, 57, 96 – 104 99
Table 1. Patient and infection demographics.
Age |
Indication for MCS |
Support |
|
|
type |
7 Years Lung Transplant Graft Failure
58 Days Post Cardiac Surgery and Failure to Come Off Bypass
276 Days Cardiomyopathy / Myocarditis
Infection location( s)
Organism( s)
VV |
Blood |
Enterococcus faecalis and Coagulase Negative Staphylococcus |
VA Blood / Respiratory
VA Blood / Respiratory
Coagulase Negative Staphylococcus / Klebsiella pneumoniae
Candida albicans / Escheridia coli and Staphylococcus aureus
Day of infection
Total days of MCS
7 27
8 11
24 53
159 Days |
Pulmonary |
VV |
Respiratory |
Staphylococcus aureus |
10 |
14 |
|
Hypertension |
|
|
|
|
|
15 Years |
Sepsis |
VA |
Blood / |
Candida albicans in |
5 |
12 |
|
|
|
Respiratory |
both |
|
|
63 Days |
Sepsis |
VA |
Respiratory |
Stenotrophomonas |
5 |
372 |
112 Days |
Viral Pneumonia |
VV |
Respiratory |
Stenotrophomonas |
14 |
21 |
13 Years |
Cardiomyopathy / |
VAD |
Respiratory |
Staphylococcus aureus |
10 |
34 |
|
Myocarditis |
|
|
|
|
|
148 Days |
ECPR |
VA |
Respiratory |
Candida species * |
4 |
6 |
227 Days |
Post Cardiac Surgery and Failure to Come Off Bypass |
VA |
Blood / Respiratory |
Pseudomonas / Klebsiella and Serratia |
9 |
9 |
835 Days Cardiomyopathy / Myocarditis
126 Days Combined Bacterial and Viral Pneumonia
VAD |
Blood |
Streptococcus viridans |
10 |
38 |
|
|
and Serratia |
|
|
VV |
Respiratory |
Pseudomonas |
11 |
13 |
1 Day |
CDH / PPHN |
VA |
Blood / Urine |
Escherichia coli in both |
6 |
14 |
240 Days |
Pulmonary |
VAD |
Respiratory |
Enterobacter cloacae |
4 |
25 |
|
Hypertension |
|
|
|
|
|
6 Years |
Hypothermia and |
VA |
Respiratory |
Streptococcus |
2 |
9 |
|
Near Drowning |
|
|
pneumoniae |
|
|
25 Years |
Cystic Fibrosis |
VV |
Respiratory |
Gram Negative Rods |
3 |
7 |
|
Exacerbation |
|
|
|
|
|
90 Days |
ECPR |
VA |
Respiratory |
Serratia |
5 |
148 |
5 Days |
Post Cardiac Surgery and Failure to Come Off Bypass |
VA |
Blood |
Staphylococcus hemolyticus |
2 |
3 |
Legend: Mechanical Circulatory Support( MCS), Veno-arterial ECMO( VA), Ventricular Assist Device( VAD), Veno-veno ECMO( VV), Cannulation to MCS during ongoing cardiopulmonary resuscitation( ECPR), Congenital Diaphragmatic Hernia( CDH), Persistent Pulmonary Hypertension of the Newborn( PPHN). Only patients specified as having been post cardiac surgery and failure to come off bypass were exposed to cardiopulmonary bypass prior to their MCS support. Day of infection represents the number of days from cannulation for mechanical circulatory support, the day before cannulation is day 0, while the first day of mechanical circulatory support accounts for day 1. * Did not speciate to specific candida organism.
542 % higher( 14.9 – 95.5 mg / mL)( P < 0.001). There was no difference between pre-cannulation and average post-cannulation uninfected values of presepsin, procalcitonin or sTREM-1.
Fourteen patients had samples available during the uninfected time period for examination of biomarker kinetics. The kinetics for the first five days of cannulation are presented in Figure 1 and Supplemental Figure 1. The absolute values for each biomarker over the first five days of support are presented in Table 3. The kinetics of and absolute values for each biomarker based on mode of support for the first five days of cannulation are presented in Supplemental Figure 2 and Supplemental Table 6 respectively.
Thirteen patients were available for the analysis of the biomarker response to infection on MCS for each of the four biomarkers, displayed in Figure 2 and Supplemental Figure 3. The absolute values of each biomarker in advance of infection