Independent Risk Factors for Ventilator-Associated Pneumonia After Cardiac Surgery

Autor:	Zhaozhuo Niu, Quan-sheng Xing, Long Sun, Yi-fan Chi, Wen-ming Hou, Wei Sheng, Ming-shan Lin
Rok vydání:	2014
Předmět:	Adult Male China medicine.medical_specialty Microbiological culture Adolescent Gram-positive bacteria medicine.medical_treatment Young Adult Risk Factors Internal medicine Pneumonia Bacterial medicine Humans Cardiac Surgical Procedures Risk factor Child Aged Retrospective Studies Aged 80 and over Mechanical ventilation biology business.industry Incidence Ventilator-associated pneumonia Pneumonia Ventilator-Associated Perioperative Middle Aged medicine.disease biology.organism_classification Cardiac surgery Surgery Pneumonia Child Preschool Multivariate Analysis Female business
Zdroj:	Journal of Investigative Surgery. 27:256-261
ISSN:	1521-0553 0894-1939
DOI:	10.3109/08941939.2014.892652
Popis:	To investigate the related factors and pathogens of ventilator-associated pneumonia (VAP) after heart surgery so as to provide evidences for clinical prevention and therapy.In total 1,688 cases were collected from January 2004 to January 2011. Overall 105 patients developed VAP. Retrospectively analyzed these patients after heart surgery to determine the clinical data, pathogens and treatment measures.The frequency of ventilator-associated pneumonia was 6.2% (105/1 688), and mortality was 25.7% (27/105), 198 pathogen strains were isolated by bacterial culture, in which Gram negative bacteria accounted for 69.2% (137/198), Gram positive bacteria 27.8% (55/198), and fungi 3.0% (6/198). The independent risk factors for VAP after cardiac surgery were: age70 (p.01), emergent surgery (p.01), perioperative blood transfusions (p0.01), reintubation (p.01) and days of mechanical ventilation (MV) (p.01). Median length of stay in the ICU for patients who developed VAP or not was, respectively, (24.7 ± 4.5) days versus (3.2 ± 1.5) days (p.05), and mortality was, respectively, 25.7% versus 2.9% in both populations (p.05).Age70, emergent surgery, perioperative blood transfusions, reintubation and days of MV are the risk factors for VAP in patients following cardiac surgery. P. aeruginosa, P. klebsiella, S. aureus, and Acinetobacter baumannii were the main pathogens of VAP. According to the cause of VAP, active prevention and treatment measures should be developed and applied to shorten the time of MV and improve chances of survival.
Databáze:	OpenAIRE
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