LAUSR

Abstract Background Patients on ECMO are at higher risk for nosocomial infections. While several studies report on infections in ECMO patients, the epidemiology of infections in burn patients on ECMO has not been previously described. Methods A retrospective chart review was performed on all patients on ECMO for >48 hours at Brooke Army Medical Center and the U.S. Army Institute of Surgical Research Burn Center between 2012 and 2017. Patient demographics, burn status, ECMO characteristics, and infection incidence during ECMO were captured. Statistical analyses comparing burn vs. nonburn patients were performed using chi-squared, Fisher’s exact and Mann–Whitney U tests. Results In comparison with those without diagnosed infections, infected patients had more days on ECMO (median [IQR] 16 [12–20] vs. 6.5 [5–10], P < 0.01) and longer hospitalization (median [IQR] 35 [24–54] vs. 23.5 days [8–45], P = 0.06), however survival to hospital discharge was no different (64% vs. 58%, P = 0.77). Burn patients trended toward more infections in their ECMO course (table). Burn (n = 14) Nonburn (n = 38) P-Value Median age (years) 29.5 (25–39) 39 (29.5–55.5) 0.05 Gender, male 9 (64%) 25 (74%) 1 Median days on ECMO 14 (8–18) 9 (5–14) 0.26 Survival to discharge 9 (64%) 23 (72%) 1 Median length of stay (days) 34 (25–47) 24 (11–50) 0.23 Median burn % total body surface area (%TBSA) 25 (21–40) n/a n/a Infections on ECMO Any infection 10 (71%) 18 (47%) 0.21 Multiple infections 7 (50%) 9 (24%) 0.07 Respiratory infection (RI) 9 (64%) 13 (34%) 0.07 Blood stream infection (BSI) 4 (28.6%) 7 (18.4%) 0.46 Other infection 5 (35.7%) 9 (24%) 0.49 Median time to RI diagnosis (days) 3 (1–9) 2 (1–6.5) 0.79 Median time to BSI diagnosis (days) 2.5 (2–5) 5 (1–2) 0.74 Total infections per 1000 ECMO days 99.7 50.6 0.02 RI per 1,000 ECMO days 49.9 22.7 0.12 BSI per 1,000 ECMO days 22.1 12.2 0.52 All data expressed as number N, % or median, interquartile range (IQR) unless otherwise stated. Conclusion Infection is a common complication of ECMO and is associated with longer duration on ECMO and longer hospitalizations. Burn patients in this cohort were observed to have higher rates of infection compared with nonburn patients. Disclosures All authors: No reported disclosures.