[The clinical features of postoperative ventilator-associated pneumonia after lung surgery].
OBJECTIVE
To investigate the clinical features of postoperative ventilator-associated pneumonia (VAP) after lung surgery.


METHODS
Of 104 patients who had undergone lung surgery and been treated with ventilator in our surgical intensive care unit between January 2003 and March 2005, 35 patients met with the criteria of both VAP and postoperative pneumonia (POP), and 41 cases had no evidences of pneumonia. The clinical and laboratory data of all 76 cases were recorded and analyzed by a statistical software package (SPSS).


RESULTS
The diagnosis of postoperative VAP was established clinically in 35 patients (46.1%), and etiologically in 33 cases. Compared to the patients without postoperative VAP, the patients with postoperative VAP had a significantly longer mean interval between intubation and operation [(2.7 +/- 2.9) days vs. (1.6 +/- 1.7) days, P = 0.039], a longer duration of mechanical ventilation [(32.2 +/- 37.7) days vs. (4.2 +/- 2.9) days, P < 0.001], and higher morbidity (20.0% vs. 2.4%, P = 0.013). There was a significant difference in mean duration of mechanical ventilation between the 15 cases of early-onset VAP and 20 cases of late-onset VAP (17 +/- 15 days vs. 43 +/- 46 days, P = 0.042). Among the initially detected pathogen, Staphylococcus aureus remains the most common Gram-positive coccus whereas Acinetobacter Baumannii took the place of Pseudomonas aeruginosa as the top Gram-negative rod.


CONCLUSIONS
Postoperative VAP after lung surgery has different clinical features from VAP in medical ICU.
Wang
Xing-an
XA
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Shanghai 200433, China. wangxingan@yahoo.com
Tong
Wen-pu
WP
Jiang
Ge-ning
GN
Ding
Jia-an
JA
Zhou
Yi-ming
YM
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011183:Postoperative Complications; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors