Relationship Between Blood Transfusion Therapy And Nosocomial Infection And Death In Patients Receiving Extracorporeal Membrane Oxygenation

Objective: To analyze the relationship between blood transfusion therapy and nosocomial infection and death in patients receiving extracorporeal membrane oxygenation(ECMO).Methods:A total of 83 adult patients who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University and received ECMO treatment from December 2017 to July2022 were retrospectively selected as the study subjects.All patients received venousarterial extracorporeal membrane oxygenation(VA-ECMO)treatment.If a large amount of blood loss(> 20 ml/kg of blood loss)occurred during the ECMO treatment,patients should receive blood transfusion therapy.The clinical data of patients were collected and patients were divided into blood transfusion group(n=45)and non blood transfusion group(n=38)according to whether they received blood transfusion therapy.Multivariate Logistic regression analysis was used to investigate the influencing factors of nosocomial infection and death in patients receiving ECMO treatment.Results: The incidence of cardiogenic shock,the proportion of patients treated with intra aortic balloon pump(IABP),the proportion of patients undergoing cardiopulmonary resuscitation before ECMO treatment,white blood cell count(WBC),neutrophil count(N),international normalized ratio(INR),aspartate transaminase(AST),alanine aminotransferase(ALT)and lactic acid after blood transfusion treatment,the incidence of nosocomial infection and mortality in the blood transfusion group were higher than those in the non blood transfusion group,hemoglobin(Hb),red blood cell count(RBC)and platelet count(PLT)before blood transfusion treatment and Hb,RBC,PLT,fibrinogen(FIB)and albumin after blood transfusion treatment in blood transfusion group were lower than those in non blood transfusion group(P < 0.05).Multivariate Logistic regression analysis showed that blood transfusion therapy was an influencing factor of nosocomial infection in patients receiving ECMO treatment [OR=5.499,95%CI(1.451,21.848),P < 0.05];left ventricular ejection fraction [OR=0.899,95%CI(0.816,0.991)] and lactic acid [OR=1.595,95%CI(1.120,2.269)] after blood transfusion therapy were influencing factors of the death of patients receiving ECMO treatment(P < 0.05).Conclusion: Blood transfusion therapy was a risk factor for nosocomial infection in patients receiving ECMO treatment,but was not associated with patient death.