Cold Atmospheric Plasma Therapy: An Innovative Approach to Treating Driveline Infections in Left Ventricular Assist Device Recipients

BACKGROUND: Driveline infections (DLIs) remain a present problem in left ventricular assist device (LVAD) patients, impacting quality of life and outcomes. The aim of this study was to evaluate the efficacy of usual care versus cold atmospheric plasma (CAP) for the treatment of DLI with three contemporary LVADs. METHODS: This single center cohort study analyzed 78 LVAD outpatients, who developed a DLI during follow-up and were treated with standard care (n = 36), involving targeted antibiotics, silver-based dressings, surgical debridement, VAC-therapy, and in severe cases, pump replacement. The CAP (SteriPlas, Adtec Healthcare, UK) cohort received adjuvant CAP therapy (n = 42) 2-3× per week. The primary outcome was the efficiency of CAP treatment for DLI (wound healing) 12 months after start of intervention stratified by usual care versus CAP. Secondary outcomes included freedom from DLI-related hospital readmission, pump exchange and VAC implantation, as well as an analysis of CAP-specific parameters. RESULTS: A total of 943 CAP sessions were performed with a median number of 17 (8; 36) sessions per patient. No side effects or pump malfunctions were observed during CAP therapy. Patients with more severe DLIs (higher DESTINE staging) required more CAP sessions to achieve healing (r = 0.42, p = 0.049). CAP versus usual care resulted in higher rates of wound healing (50% vs. 25%, p = 0.03) and less DLI-related hospital readmissions (19.0% vs. 54.5%, p < 0.001). CONCLUSION: Regardless of the type of bacteria, CAP provides a safe, non-contact therapy and easy treatment option for DLIs with significant improvement in LVAD patient outcomes and quality of life.