{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:01:12Z","timestamp":1781157672826,"version":"3.54.1"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014895","name":"Southwest Medical University","doi-asserted-by":"crossref","award":["2023QN050"],"award-info":[{"award-number":["2023QN050"]}],"id":[{"id":"10.13039\/501100014895","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nosocomial infection (NSI) is a serious complication in extracorporeal membrane oxygenation (ECMO) patients, yet reported risk factors remain inconsistent. A systematic synthesis is needed to identify key predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA guidelines, this meta-analysis (PROSPERO: CRD420251161290) searched five databases for studies reporting multivariate risk factors for NSI in adult ECMO patients. Study selection, data extraction, and quality assessment (Newcastle-Ottawa Scale) were performed independently by two reviewers. Pooled odds ratios (ORs) were calculated with random-effects models; heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      \u202f\u2265\u202f50%) was explored via meta-regression and subgroup analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-four observational studies (\u22488,901 patients) were included. Significant risk factors were: immunosuppression (OR 2.21, 95% CI 1.27\u20133.85), inter-hospital transport (2.24, 1.04\u20134.80), pre-ECMO infection (2.54, 2.03\u20133.18), higher SOFA score (per point: 1.13, 1.03\u20131.24), prolonged ECMO duration (per day: 1.10, 1.07\u20131.14), continuous renal replacement therapy (2.18, 1.57\u20133.02), and catheter intubation (1.24, 1.02\u20131.51). ECMO duration showed high heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f89.9%), largely driven by small-study effects. Age, body mass index, diabetes mellitus, and hypertension were not significantly associated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NSI in ECMO patients arises from an interplay of baseline characteristics, illness severity, and invasive support duration\/intensity. A stratified, risk-factor-based prevention strategy is warranted. Given the predominantly retrospective evidence, prospective studies are required for validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251161290<\/jats:uri>\n                      , Identifier: CRD420251161290.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1820017","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:47:05Z","timestamp":1781156825000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for nosocomial infections in ECMO patients: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Jia","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Neijiang Hospital of Traditional Chinese Medicine","place":["Neijiang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Neijiang First People's Hospital","place":["Neijiang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YanFang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]},{"name":"Department of Infection Management, Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.12669\/pjms.36.6.2882","article-title":"Bloodstream infections in patients undergoing extracorporeal membrane oxygenation","volume":"36","author":"Wang","year":"2020","journal-title":"Pak J Med Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1097\/CCM.0000000000002652","article-title":"Nosocomial infections during extracorporeal membrane oxygenation: incidence, etiology, and impact on patients' outcome","volume":"45","author":"Grasselli","year":"2017","journal-title":"Crit Care Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1093\/cid\/cis783","article-title":"Nosocomial infections in adult cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation","volume":"55","author":"Schmidt","year":"2012","journal-title":"Clin Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1097\/PCC.0b013e3181e28894","article-title":"Extracorporeal life support organization task force on infections, extracorporeal membrane oxygenation. Infections acquired during extracorporeal membrane oxygenation in neonates, children, and adults","volume":"12","author":"Bizzarro","year":"2011","journal-title":"Pediatr Crit Care Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.jhin.2009.07.016","article-title":"Risk factors for nosocomial infection during extracorporeal membrane oxygenation","volume":"73","author":"Hsu","year":"2009","journal-title":"J Hosp Infect"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1086\/668439","article-title":"Infections acquired by adults who receive extracorporeal membrane oxygenation: risk factors and outcome","volume":"34","author":"Aubron","year":"2013","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1016\/j.jtcvs.2010.07.017","article-title":"Infections occurring during extracorporeal membrane oxygenation use in adult patients","volume":"140","author":"Sun","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"593","DOI":"10.3346\/jkms.2017.32.4.593","article-title":"Nosocomial infection in adult patients undergoing Veno-arterial extracorporeal membrane oxygenation","volume":"32","author":"Kim","year":"2017","journal-title":"J Korean Med Sci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur J Epidemiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1097\/MAT.0000000000000771","article-title":"Cannula-related infection in patients supported by peripheral ECMO: clinical and microbiological characteristics","volume":"65","author":"Allou","year":"2019","journal-title":"ASAIO J"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1186\/2197-425X-3-S1-A368","article-title":"Risk predictors of infection and mortality in population of cardiac surgery patients on ecmo therapy","volume":"3","author":"Bachleda","year":"2015","journal-title":"Intensive Care Med Exp"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e995","DOI":"10.1093\/cid\/ciaa1748","article-title":"Risk factors and outcomes of hospitalized patients with severe coronavirus disease 2019 (COVID-19) and secondary bloodstream infections: a multicenter case-control study","volume":"72","author":"Bhatt","year":"2021","journal-title":"Clin Infect Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e0194976","DOI":"10.1371\/journal.pone.0194976","article-title":"Ventilator-associated pneumonia in patients assisted by veno-arterial extracorporeal membrane oxygenation support: epidemiology and risk factors of treatment failure","volume":"13","author":"Bougl\u00e9","year":"2018","journal-title":"PLoS One"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.hrtlng.2023.07.012","article-title":"Bloodstream infections in COVID-19 patients undergoing extracorporeal membrane oxygenation in ICU: an observational cohort study","volume":"62","author":"Carelli","year":"2023","journal-title":"Heart Lung"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1016\/j.ajic.2024.06.008","article-title":"Frequency, characteristics, and outcome of adult patients with multiple consecutive health care-associated infections undergoing extracorporeal membrane oxygenation: a retrospective analysis","volume":"52","author":"Deng","year":"2024","journal-title":"Am J Infect Control"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/j.hrtlng.2018.07.004","article-title":"Incidence of nosocomial infections in adult patients undergoing extracorporeal membrane oxygenation","volume":"47","author":"Juthani","year":"2018","journal-title":"Heart Lung"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1155\/ijcp\/4985868","article-title":"Analysis of pathogenic bacteria and associated risk factors of bloodstream infections in ICU patients undergoing ECMO support using mNGS technology","volume":"1","author":"Kang","year":"2025","journal-title":"Int J Clin Pract"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e0243838","DOI":"10.1371\/journal.pone.0243838","article-title":"Nosocomial infections in in-hospital cardiac arrest patients who undergo extracorporeal cardiopulmonary resuscitation","volume":"15","author":"Ko","year":"2020","journal-title":"PLoS One"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1016\/j.xjon.2023.06.024","article-title":"Prophylactic antibiotic treatment for preventing nosocomial infection in extracorporeal membrane oxygenation-resuscitated circulatory arrest patients","volume":"16","author":"Kuo","year":"2023","journal-title":"JTCVS Open"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"493","DOI":"10.23736\/S0375-9393.17.11659-7","article-title":"Nosocomial blood stream infections in patients treated with venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome","volume":"83","author":"Kutle\u0161a","year":"2017","journal-title":"Minerva Anestesiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"15059","DOI":"10.1038\/s41598-022-19405-z","article-title":"Clinical and microbiological characteristics of and risk factors for bloodstream infections among patients with extracorporeal membrane oxygenation: a single-center retrospective cohort study","volume":"12","author":"Lee","year":"2022","journal-title":"Sci Rep"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.2147\/IDR.S306209","article-title":"Analysis of nosocomial infection and risk factors in patients with ECMO treatment","volume":"14","author":"Li","year":"2021","journal-title":"Infect Drug Resist"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1177\/0267659121100776","article-title":"Impact of immunomodulatory drugs on infectious complications in COVID-19 patients on extracorporeal membrane oxygenation: analysis of the ELSO registry, EuroELSO 2021","volume":"24","author":"Ling","year":"2021","journal-title":"Perfusion"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1097\/MAT.0000000000001575","article-title":"Indwelling central venous catheters drive bloodstream infection during Veno-venous extracorporeal membrane oxygenation support","volume":"68","author":"Manerikar","year":"2022","journal-title":"ASAIO J"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1017\/ice.2021.251","article-title":"Rates of nosocomial infection associated with interhospital transfer of patients receiving extracorporeal membrane oxygenation","volume":"43","author":"Marcus","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13613-023-01120-1","article-title":"Multiple-site decontamination to prevent acquired infection in patients with veno-venous ECMO support","volume":"13","author":"Massart","year":"2023","journal-title":"Ann Intensive Care"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1017\/ice.2018.90","article-title":"Blood stream infection in patients on Venovenous extracorporeal membrane oxygenation for respiratory failure","volume":"39","author":"Na","year":"2018","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"4429","DOI":"10.21037\/jtd-23-1912","article-title":"Dynamic decline of lymphocytes predicts extracorporeal membrane oxygenation-related infections: a retrospective observational study","volume":"16","author":"Hao","year":"2024","journal-title":"J Thorac Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.3390\/microorganisms11041079","article-title":"Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit","volume":"11","author":"Mornese Pinna","year":"2023","journal-title":"Microorganisms"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1007\/s10096-018-3241-7","article-title":"Invasive pulmonary aspergillosis is associated with adverse clinical outcomes in critically ill patients receiving veno-venous extracorporeal membrane oxygenation","volume":"37","author":"Rodriguez-Goncer","year":"2018","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2260","DOI":"10.1016\/j.jpedsurg.2011.09.013","article-title":"Defining risk for infectious complications on extracorporeal life support","volume":"46","author":"Vogel","year":"2011","journal-title":"J Pediatr Surg"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"743","DOI":"10.21470\/1678-9741-2020-0068","article-title":"Extracorporeal membrane oxygenation-related nosocomial infection after cardiac surgery in adult patients","volume":"36","author":"Wang","year":"2021","journal-title":"Braz J Cardiovasc Surg"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"300060520964701","DOI":"10.1177\/0300060520964701","article-title":"Risk factors and prognosis of nosocomial pneumonia in patients undergoing extracorporeal membrane oxygenation: a retrospective study","volume":"48","author":"Wang","year":"2020","journal-title":"J Int Med Res"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1016\/j.ajic.2023.04.010","article-title":"Nosocomial infections in adult patients receiving extracorporeal membrane oxygenation in China: a retrospective cohort study","volume":"51","author":"Wang","year":"2023","journal-title":"Am J Infect Control"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1097\/MAT.0000000000001505","article-title":"Extracorporeal membrane oxygenation cannula-related infections: epidemiology and risk factors","volume":"68","author":"Winiszewski","year":"2022","journal-title":"ASAIO J"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"4117","DOI":"10.2147\/IDR.S372913","article-title":"Nosocomial infections in nonsurgical patients undergoing extracorporeal membrane oxygenation: a retrospective analysis in a Chinese hospital","volume":"15","author":"Xu","year":"2022","journal-title":"Infect Drug Resist"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1186\/s12890-022-02164-y","article-title":"Risk factors for bloodstream infection (BSI) in patients with severe acute respiratory distress syndrome (ARDS) supported by veno-venous extracorporeal membrane oxygenation (VV-ECMO)","volume":"22","author":"Yang","year":"2022","journal-title":"BMC Pulm Med"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1186\/s13054-020-03310-w","article-title":"Chlorhexidine bathing of the exposed circuits in extracorporeal membrane oxygenation: an uncontrolled before-and-after study","volume":"24","author":"Yeo","year":"2020","journal-title":"Crit Care"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"857873","DOI":"10.3389\/fpubh.2022.857873","article-title":"Outcome and clinical characteristics of nosocomial infection in adult patients undergoing extracorporeal membrane oxygenation: a systematic review and meta-analysis","volume":"10","author":"Li","year":"2022","journal-title":"Front Public Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e0308078","DOI":"10.1371\/journal.pone.0308078","article-title":"Risk factors for nosocomial infection in patients undergoing extracorporeal membrane oxygenation support treatment: a systematic review and meta-analysis","volume":"19","author":"Lv","year":"2024","journal-title":"PLoS One"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s13054-024-04946-8","article-title":"Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis","volume":"28","author":"Ait Hssain","year":"2024","journal-title":"Crit Care"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"271","DOI":"10.3389\/fendo.2017.00271","article-title":"Diabetes and sepsis: risk, recurrence, and ruination","volume":"8","author":"Frydrych","year":"2017","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"377","DOI":"10.3390\/jof11050377","article-title":"Retrospective analysis of fungal isolations in patients on veno-venous extracorporeal membrane oxygenation: the multicenter RANGER STUDY 2.0","volume":"11","author":"Boscolo","year":"2025","journal-title":"J Fungi (Basel)"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s13054-024-05231-4","article-title":"Correction to: retrospective ANalysis of multi-drug resistant gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY","volume":"29","author":"Boscolo","year":"2025","journal-title":"Crit Care"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1007\/s00134-025-07877-2","article-title":"Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis","volume":"51","author":"Pettenuzzo","year":"2025","journal-title":"Intensive Care Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"101319","DOI":"10.1016\/j.accpm.2023.101319","article-title":"Infection in ECMO patients: changes in epidemiology, diagnosis and prevention","volume":"43","author":"Pe\u00f1a-L\u00f3pez","year":"2024","journal-title":"Anaesth Crit Care Pain Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1016\/j.ajic.2024.05.005","article-title":"A systematic review of variability in the reporting of extracorporeal membrane oxygenation-associated infections and recommendations for standardization","volume":"52","author":"Sweet","year":"2024","journal-title":"Am J Infect Control"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1086\/676533","article-title":"Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update","volume":"35","author":"Marschall","year":"2014","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s13613-020-00713-4","article-title":"Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit","volume":"10","author":"Timsit","year":"2020","journal-title":"Ann Intensive Care"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"2153","DOI":"10.1007\/s00134-018-5442-z","article-title":"Percutaneous versus surgical femoro-femoral veno-arterial ECMO: a propensity score matched study","volume":"44","author":"Danial","year":"2018","journal-title":"Intensive Care Med"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1017\/ice.2022.88","article-title":"Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 update","volume":"43","author":"Klompas","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1016\/j.idc.2021.07.004","article-title":"Prevention of central-line associated bloodstream infections: 2021 update","volume":"35","author":"Selby","year":"2021","journal-title":"Infect Dis Clin N Am"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s13012-021-01112-4","article-title":"Results of the CHlorhexidine gluconate bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections study (CHanGing BathS): a stepped wedge cluster randomized trial","volume":"16","author":"Reynolds","year":"2021","journal-title":"Implement Sci"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.cmi.2017.08.019","article-title":"Selective digestive and oropharyngeal decontamination in medical and surgical ICU patients: individual patient data meta-analysis","volume":"24","author":"Plantinga","year":"2018","journal-title":"Clin Microbiol Infect"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"g2197","DOI":"10.1136\/bmj.g2197","article-title":"Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis","volume":"348","author":"Price","year":"2014","journal-title":"BMJ"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1007\/s00134-021-06526-8","article-title":"Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial","volume":"47","author":"Boh\u00e9","year":"2021","journal-title":"Intensive Care Med"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"e24329","DOI":"10.1097\/MD.0000000000024329","article-title":"Early versus late tracheotomy in ICU patients: a meta-analysis of randomized controlled trials","volume":"100","author":"Deng","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"CD007271","DOI":"10.1002\/14651858.CD007271.pub3","article-title":"Early versus late tracheostomy for critically ill patients","volume":"1","author":"Andriolo","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of Adults with Hospital-acquired and Ventilator-associated Pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin Infect Dis"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving Sepsis campaign: international guidelines for Management of Sepsis and Septic Shock: 2016","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1007\/s00134-020-05950-6","article-title":"Bloodstream infections in critically ill patients: an expert statement","volume":"46","author":"Timsit","year":"2020","journal-title":"Intensive Care Med"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1820017\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:47:07Z","timestamp":1781156827000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1820017\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":62,"alternative-id":["10.3389\/fpubh.2026.1820017"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1820017","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"article-number":"1820017"}}