Title: Clinical and etiological analysis of ventilator-associated pneumonia in adult patients following heart valve surgery
Abstract: Objective The aim of this study was to investigate the clinical characteristics of ventilator-associated pneumonia (VAP) and the pathogens in adult patients undergoing heart valve surgery of cardiopulmonary bypass (CPB). Methods The clinical data,pathogen pattern and associated risk factors of VAP were analyzed in adult patients following heart valve surgery.Results Of the 77 patients following heart valve surgery,34 developed VAP. The incidence was 44.2%. Of these 34 cases,11 were early-onset VAP and 23 were late-onset VAP. Multivariate analysis indicated that severe pulmonary hypertension,CPB time 120 min,transfusion of red blood cell ≥ 6 u,PaO2/FiO2 ≤300 mmHg,ventilation time ≥ 4 days and tracheotomy were significant risk factors of VAP. The proportion of gram-positive bacteria (69.2%) was significantly higher in early-onset VAP sputum culture,while the proportion of gram-negative bacteria (45.5%) and fungus (27.3%) were significantly higher in late-onset VAP (χ 2 =7.034,P=0.030). Conclusions This study shows that the severe pulmonary hypertension,longer CPB time,longer ventilation time,hypoxemia,red blood cell transfusion and tracheotomy are risk factors most likely associated with development of VAP in adult patients following heart valve surgery. There is difference in the sputum pathogens between early-onset and late-onset VAP.
Publication Year: 2009
Publication Date: 2009-01-01
Language: en
Type: article
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