Clinical study of ventilator-associated pneumonia in children after surgical correction for tetralogy of Fallot
10.7507/1007-4848.201810039
- VernacularTitle:儿童法洛四联症术后呼吸机相关性肺炎的临床研究
- Author:
ZENG Xiaodong
1
,
2
;
CHEN Jimei
1
,
2
;
ZHUANG Jian
1
,
2
;
ZHU Weizhong
1
,
2
;
LUO Dandong
1
,
2
;
LEI Liming
1
,
2
;
GE Tongkai
1
,
2
Author Information
1. Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People'
2. s Hospital, Guangdong Academy of Medical Science, Guangzhou, 510080, P.R.China
- Publication Type:Journal Article
- Keywords:
Tetralogy of Fallot;
ventilator-associated pneumonia;
incidence;
pathogen;
risk factor;
outcome
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(6):528-533
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the incidence, pathogens, risk factors and clinical outcomes for ventilator-associated pneumonia (VAP) in children after tetralogy of Fallot (TOF) surgical correction, in order to offer reliable data for the prevention of VAP. Methods This was a retrospective study performed in Guangdong General Hospital and 181 children (121 males, 60 females, mean age of 11.2±10.4 months) undergoing surgical correction for TOF were included. ALL the children who received mechanical ventilation for 48 hours or longer between January 2013 and December 2017 were classified into a VAP group (n=44) and a non-VAP group (n=137). T test, χ2 test and multiple logistic regression analysis were used to identify the possible risk factors for VAP. Results This study enrolled 181 patients , of which 44 were diagnosed as VAP. And the incidence of VAP was 24.3%. The most frequent isolated pathogen was Gram-negative bacteria (69.7%). Single factor analysis showed that the variables significantly associated with a risk factor of VAP were: hypoxic spells, preoperative pneumonia, preoperative mechanical ventilation support, cardiopulmonary bypass (CPB) time, reintubation, pulmonary atelectasis, low cardiac output syndrome (LCOS), intra-abdominal drainage and transfusion of fresh frozen plasma. The multiple logistic regression showed CPB time (OR=1.011), reintubation (OR=14.548), pulmonary atelectasis (OR=6.139) and LCOS (OR=3.054) were independent risk factors for VAP in children after TOF surgical correction. Patients with VAP had prolonged duration of mechanical ventilation, a longer ICU stay and longer hospitalization time. Conclusions The VAP rate in this population is higher than that reported abroad, which leads to prolonged duration of mechanical ventilation and a longer hospital stay. The effective measures for prevention of VAP should be taken according to the related risk factors for VAP to decrease the incidence of VAP in children after TOF surgical correction.
