Abstract:

Objective: This study aimed to explore the impact of feedforward control in preventing catheter-related bloodstream infections in patients undergoing long-term veno-venous extracorporeal membrane oxygenation (V-V ECMO) treatment. Methods: A retrospective observational study was conducted on 18 patients receiving long-term V-V ECMO treatment at an ICU in Wuhan Pulmonary Hospital from January 2021 to December 2023. The study assembled a feedforward control special management team, engaged multidisciplinary medical infection control professionals for quality management, utilized ‘experiential’ and ‘scenario simulation exercise’ teaching methods for medical operation training and assessment, and applied treatment forms for quality control. Indicators such as ECMO catheter-related bloodstream infection rate, effective ECMO withdrawal rate, ECMO survival rate, and patient prognosis were monitored. Results: Totally 18 patients underwent 540 days of ECMO treatment without any catheter-related bloodstream infections. Among these patients, 10 were successfully weaned off ECMO, resulting in an effective withdrawal rate of 55.6%. Seven patients survived post-discharge, indicating a survival rate of 38.9%. Two patients returned to work, while two managed self-care at home, and two required assistance with daily activities. One patient, suffering from craniocerebral disease, was bedridden and needed daily care. Conclusion: The study concludes that the implementation of feedforward control measures can enhance patient safety during long-term V-V ECMO treatment, reduce the risk of ECMO catheter-related bloodstream infections.

Key words: Extracorporeal membrane oxygenation, Bacterial infections, Patient care management