title: [Clinical analysis of 105 cases of ventilator-associated pneumonia after heart surgery].
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 Staphylococcus 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. Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Staphylococcus aureus are the main pathogens of VAP.
authors.affiliation: Department of Cardiovascular Surgery, Qingdao Municipal Hospital, Qingdao, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sheng
authors.forename: Yi-fan
authors.initials: YF
authors.lastname: Chi
authors.forename: Wen-ming
authors.initials: WM
authors.lastname: Hou
authors.forename: Long
authors.initials: L
authors.lastname: Sun
authors.forename: Zhao-zhuo
authors.initials: ZZ
authors.lastname: Niu
authors.forename: Yong
authors.initials: Y
authors.lastname: Sun
authors.forename: Ming-shan
authors.initials: MS
authors.lastname: Lin
mesh_terms: D040981:Acinetobacter baumannii; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D053717:Pneumonia, Ventilator-Associated / Q000382:microbiology*; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D012307:Risk Factors