title: Independent risk factors for ventilator-associated pneumonia after cardiac surgery.
abstract: OBJECTIVE
  To investigate the related factors and pathogens of ventilator-associated pneumonia (VAP) after heart surgery so as to provide evidences for clinical prevention and therapy.
  
  
  METHODS
  In total 1,688 cases were collected from January 2004 to January 2011. Overall 105 patients developed VAP. Retrospectively analyzed these patients after heart surgery to determine the clinical data, pathogens and treatment measures.
  
  
  RESULTS
  The frequency of ventilator-associated pneumonia was 6.2% (105/1 688), and mortality was 25.7% (27/105), 198 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 3.0% (6/198). The independent risk factors for VAP after cardiac surgery were: age >70 (p < .01), emergent surgery (p < .01), perioperative blood transfusions (p < 0.01), reintubation (p < .01) and days of mechanical ventilation (MV) (p < .01). Median length of stay in the ICU for patients who developed VAP or not was, respectively, (24.7 ± 4.5) days versus (3.2 ± 1.5) days (p < .05), and mortality was, respectively, 25.7% versus 2.9% in both populations (p < .05).
  
  
  CONCLUSIONS
  Age >70, emergent surgery, perioperative blood transfusions, reintubation and days of MV are the risk factors for VAP in patients following cardiac surgery. P. aeruginosa, P. klebsiella, S. aureus, and Acinetobacter baumannii were the main pathogens of VAP. According to the cause of VAP, active prevention and treatment measures should be developed and applied to shorten the time of MV and improve chances of survival.
authors.affiliation: 1Department of Cardiovascular Surgery, Qingdao Municipal Hospital, Medical College of Qingdao University, Qingdao, Shandong, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sheng
authors.forename: Quan-Sheng
authors.initials: QS
authors.lastname: Xing
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: Ming-Shan
authors.initials: MS
authors.lastname: Lin
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Chi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: cardiac surgery; pathogen; risk factor; ventilator-associated pneumonia (VAP)