Retrospective Analysis of Infection in Patients Undergoing Support With Left Ventricular Assist Systems

Springer, W; Wasler, A.; Radovančević, Branislav; Myers, Timothy J.; Odegaard, Peggy; Macris, Michael P.; Frazier, O.H.

doi:10.1097/00002480-199609000-00092

Cited by 29 publications

(16 citation statements)

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“…In a current case series, 62 85% of LVAD infections occurred when the device was left in place for Ͼ2 weeks. The incidence of infection has been highly variable among different surveys [63][64][65][66][67][68][69][70][71][72][73][74][75] and has been reported to range between 13% and 80%. The wide variability in infection risk is, in part, due to different types of infections that have been included under the category of LVAD-related infections.…”

Section: Left Ventricular Assist Devicesmentioning

confidence: 99%

Nonvalvular Cardiovascular Device–Related Infections

Baddour¹,

Bettmann²,

Bolger³

et al. 2003

Circulation

447

326

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Section: Left Ventricular Assist Devicesmentioning

confidence: 99%

Nonvalvular Cardiovascular Device–Related Infections

Baddour¹,

Bettmann²,

Bolger³

et al. 2003

Circulation

447

326

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“…Furthermore, there was a trend toward a longer duration of VAD support among infected patients, compared with uninfected patients (66.9 ‫ע‬ days vs. days; ). 76.0 26.9 ‫ע‬ 34.2 P p .06 As reported by other authors, the most common sites of infection included the lungs, blood, and cannulas [12]. The most frequently isolated organisms included Staphylococcus species and P. aeruginosa.…”

Section: Discussionmentioning

confidence: 71%

“…P ! .05 However, many other reports did not find an influence of infection on overall survival [12,31,32]. In all these studies, infection did not preclude heart transplantation or alter the survival rate after transplantation [12,[30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Infections Occurring during Receipt of Circulatory Support with the Paracorporeal Ventricular Assist System

Mekontso-Dessap¹,

Kirsch

Vermès

et al. 2002

CLIN INFECT DIS

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This retrospective study sought to report the spectrum of infections in a homogenous group of 39 patients who underwent implantation of the Thoratec paracorporeal ventricular assist device system (Thoratec Laboratories) in an emergency setting. Thirty-one of the 39 patients developed a total of 99 nosocomial infections (attack rate, 79.5%; incidence, 4.9 per 100 support-days). The lungs were the most frequently involved site (31.3%), and coagulase-negative Staphylococcus species were the pathogens most frequently isolated (16.2%). Infected patients required more transfusions and chest surgical revisions, as well as a longer duration of mechanical ventilation and a longer stay in the intensive care unit, compared with uninfected patients. Cox regression analysis revealed that chest surgical revision was the only independent risk factor for infection at any site (odds ratio, 2.6; 95% confidence interval, 1.2-5.7). There was no significant effect of infection on heart transplantation rate and overall survival.

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“…Bloodstream pathogens in 1 study [62] included aerobic gram-negative bacilli (43%), yeast (20%), and gram-positive bacteria (20%). Fungal infection is a particular problem, especially in patients who have been treated with broad-spectrum antibacterials over an extended period of time [64]; however, both bacterial and fungal infections can be appropriately controlled and do not constitute a contraindication to transplantation [61][62][63]65]. Removal of the LVAD at the time of transplantation and an appropriate course of posttransplant antimicrobials are often curative.…”

Section: Special Risk Categoriesmentioning

confidence: 99%

Prophylactic Measures in the Solid‐Organ Recipient before Transplantation

Avery

Ljungman²

2001

CLIN INFECT DIS

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Pretransplant screening affords an important opportunity to detect and treat preexisting active infection in the solid-organ transplant recipient. In this article, pretransplant strategies for preventing infections after solid-organ transplantation are reviewed. In addition to the search for active preexisting infection in the transplant candidate, immunization remains a cornerstone of preventive practice. Because there is a suboptimal response to vaccinations in patients who are receiving immunosuppressive therapy, as well as in patients with end-stage organ dysfunction, standard immunization of the transplant candidate should be updated as early as possible in the course of the illness, including pneumococcal, influenza, and hepatitis B vaccines. Liver transplant candidates should receive hepatitis A vaccine, and children should receive Haemophilus influenzae type B conjugate vaccine. All nonimmune pretransplant patients should be considered candidates for the varicella vaccine. The management of special risk groups is discussed in detail.

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Retrospective Analysis of Infection in Patients Undergoing Support With Left Ventricular Assist Systems

Cited by 29 publications

References 0 publications

Nonvalvular Cardiovascular Device–Related Infections

Nonvalvular Cardiovascular Device–Related Infections

Nosocomial Infections Occurring during Receipt of Circulatory Support with the Paracorporeal Ventricular Assist System

Prophylactic Measures in the Solid‐Organ Recipient before Transplantation

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