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Performing routine blood cultures (BCs) may identify early paucisymptomatic BSIs. We investigated the contribution of systematic daily BCs to detect BSIs on V-A ECMO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study including all adult patients requiring V-A ECMO and surviving more than 24\u00a0h. Our protocol included routine daily BCs, from V-A ECMO insertion up to 5\u00a0days after withdrawal; other BCs were performed on-demand.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On the 150\u00a0V-A ECMO included, 2146 BCs were performed (1162 routine and 984 on-demand BCs); 190 (9%) were positive, including 68 contaminants. Fifty-one (4%) routine BCs revealed BSIs; meanwhile, 71 (7%) on-demand BCs revealed BSIs (<jats:italic>p<\/jats:italic>\u2009=\u20090.005). Performing routine BCs was negatively associated with BSIs diagnosis (OR 0.55, 95% CI [0.38; 0.81],<jats:italic>p<\/jats:italic>\u2009=\u20090.002). However, 16 (31%) BSIs diagnosed by routine BCs would have been missed by on-demand BCs. Independent variables for BSIs diagnosis after routine BCs were: V-A\u00a0ECMO for cardiac graft failure (OR 2.43, 95% CI [1.20; 4.92],<jats:italic>p<\/jats:italic>\u2009=\u20090.013) and sampling with on-going antimicrobial therapy (OR 2.15, 95% CI [1.08; 4.27],<jats:italic>p<\/jats:italic>\u2009=\u20090.029) or renal replacement therapy (OR 2.05, 95% CI [1.10; 3.81],<jats:italic>p<\/jats:italic>\u2009=\u20090.008). Without these three conditions, only two BSIs diagnosed with routine BCs would have been missed by on-demand BCs sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although routine daily BCs are less effective than on-demand BCs and expose to contamination and inappropriate antimicrobial therapy, a policy restricted to on-demand BCs would omit a significant proportion of BSIs. This argues for a tailored approach to routine daily BCs on V-A\u00a0ECMO, based on risk factors for positivity.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13054-021-03658-7","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T10:03:12Z","timestamp":1625738592000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnostic yield of routine daily blood culture in patients on veno-arterial extracorporeal membrane oxygenation"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4323-876X","authenticated-orcid":false,"given":"Quentin","family":"de Roux","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Renaudier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wulfran","family":"Bougouin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Boccara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Fihman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rapha\u00ebl","family":"Lepeule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chamsedine","family":"Cherait","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Fiore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Hemery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Winoc","family":"Decousser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Langeron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Mongardon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"issue":"3","key":"3658_CR1","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.accpm.2017.10.002","volume":"37","author":"N Mongardon","year":"2018","unstructured":"Mongardon N, De Roux Q, Clariot S. 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This study was approved by the Comit\u00e9 d\u2019Ethique pour la Recherche en Anesth\u00e9sie-R\u00e9animation (CERAR, IRB 00010254-2019-027).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"All authors have given their consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"NM serves as a consultant for Amomed. The other authors have not disclosed any potential competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"241"}}