Outcomes associated with bacteremia in patients with axillary mechanical circulatory support devices Diane Dreucean, PharmD; Celia Morton, PharmD; Luma Succar, PharmD; Jill Krisl, PharmD; Katherine Perez, PharmD; Kevin Donahue, PharmD PURPOSE
RESULTS
Development of bloodstream infections (BSI) while on durable mechanical circulatory support (MCS) devices has been shown to negatively impact orthotopic heart transplantation (OHT) outcomes. However, this association has not been explored in patients on temporary MCS. The aim of this study was to assess the incidence of BSI in patients with axillary MCS devices and characterize patient outcomes following device removal.
We retrospectively reviewed 194 patients that underwent axillary MCS device placement with an intra-aortic balloon pump (IABP), Impella® 5.0, or Impella® 5.5 from May 2016 through August 2020. The primary endpoint was the incidence of BSI during axillary device support, reported as the proportion of patients who developed a BSI and BSI per 1000-device days. CONCLUSION
METHODS
We retrospectively reviewed 194 patients that underwent axillary MCS device placement with an intra-aortic balloon pump (IABP), Impella® 5.0, or Impella® 5.5 from May 2016 through August 2020. The primary endpoint was the incidence of BSI during axillary device support, reported as the proportion of patients who developed a BSI and BSI per 1000-device days.
Incidence of BSI across axillary-placed MCS devices is not well defined. Our results demonstrate that unique factors, such as longer duration of MCS or prior femoral device use, can play a role in development of BSI and warrant further investigation. Strategies to prevent BSI, including use of peri-procedural antimicrobials, may have clinical utility in improving post-device outcomes. Larger studies are needed to fully elucidate risk factors associated with BSI development in this patient population, evaluate the BSI risk profile of femoral versus axillary MCS devices, and assess the impact of BSI on patient outcomes.
PGY2 CRITICAL CARE PHARMACY RESIDENCY
Diane Dreucean, PharmD Diane completed her undergraduate coursework and earned her PharmD from the University of Houston in 2019. She completed her PGY1 at Houston Methodist Hospital. Following completion of her PGY2, Diane will be staying on at Houston Methodist Hospital as an overnight critical care clinical pharmacy specialist. Primary Project Preceptor: Kevin Donahue, PharmD, BCPS Presented at 2020 Virtual ASHP Midyear Clinical Meeting; 2021 TMC Critical Care Virtual Research Forum
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