Clinical analysis of 105 cases of ventilator-associated pneumonia after heart surgery
10.3760/cma.j.issn.0253-3758.2012.10.005
- VernacularTitle:心脏直视术后呼吸机相关性肺炎的临床分析
- Author:
Wei SHENG
1
;
Yi-Fan CHI
;
Wen-Ming HOU
;
Long SUN
;
Zhao-Zhuo NIU
;
Yong SUN
;
Ming-Shan LIN
Author Information
1. 266071,青岛市市立医院心脏外科
- Keywords:
Cardiac surgical procedures;
Pneumonia,ventilator-associated;
Risk factors
- From:
Chinese Journal of Cardiology
2012;40(10):825-829
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the related factors and pathogens of ventilator-associated pneumonia (VAP) after heart surgery.Methods VAP was diagnosed in 105 patients out of 1688 cases (6.2％) who underwent heart surgery in our department between January 2004 and January 2011.Clinical data,pathogens and treatments were analyzed.Results Incidence of VAP was 6.2％ (105/1688),and 53.0％ (105/198) in patients who required more than 48 hours of mechanical ventilation.One hundred and ninety-eight 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 for 3.0％ (6/198).Pseudomonas aeruginosa,klebsiella pneumoniae,acinetobacter baumannii,escherichia coli,and staphylocccus aureus were the main pathogens of VAP.The independent risk factors for VAP were:age ＞ 70 years,emergent surgery,perioperative transfusions,reintubation and days of mechanical ventilation(all P ＜ 0.01).Median length of stay in the ICU for patients who developed VAP or not was (24.7 ± 4.5) days versus (3.2 ±1.5)days,respectively (P ＜0.05) and in-hospital mortality was 25.7％ (27/105) versus 2.9％(46/1583) respectively (P ＜ 0.05).Conclusions Patients undergoing heart surgery have a high frequency of developing VAP,especially in patients that require more than 48 hours of mechanical ventilation.VAP is associated with high in-hospital mortality.Age ＞ 70 years,emergent surgery,perioperative transfusions,reintubation and prolonged mechanical ventilation use are independent risk factors for VAP in patients following cardiac surgery.Pseudomouas aeruginosa,klebsiella pneumoniae,acinetobacter baumannii,escherichia coli,and staphylocccus aureus are the main pathogens of VAP.
