Bacterièmia associada a la Oxigenació per Membrana Extra-Corpòria: factors associats, mesures preventives i intervencions infermeres. Revisió bibliogràfica

Abstract

The presence of viable bacteria in the bloodstream is a particularly relevant complication in people in a critical state; in the context of Extra-Corporate Membrane Oxigenation (ECMO), its incidence is very important since it can trigger a set of significant clinical, healthcare and economic repercussions. The global expansion of therapy (in more than 600 centers in 2024), makes it essential to understand and prevent this infection. Goals: Of the work has been; to identify and analyze the risk factors associated with a higher risk of bacteriemia and at the same time, to describe and synthesize nursing interventions aimed at the prevention of this pathology, in people with extra-corporeal support. Metodology: A systematic bibliographic review has been carried out in accordance with the PRISMA guide. Studies have been searched (2019-2025) in PubMed, CINAHL or Cochrane using MeSH descriptors related to therapy and bacteriemia. A set of criteria and a critical evaluation have been applied to collect the articles with more evidence. 23 articles have been included. Outcomes: Where the most consistent risk factors have been: the prolonged duration of the support, the clinical severity of the person, the ECMO-VA modality, hemodialysis, diabetes and canulation outside the operating room. Preventive strategies with the best risk-benefit balance include standardization of the canulation process, antisepsy with chlorhexidine, insertion point care, 1:1 nursing-person ratio and active microbiological surveillance. Conclusión: Bacteriemia in ECMO is frequent and multifactorial. The evidence supports a multimodal, protocolized and nursing-led preventive approach to reduce ICU stay and morbidity. Multicenter trials are required to define the optimal duration of the support and the appropriate use of antimicrobial prophylaxis

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