[Risk factors related to nosocomial pneumonia in pediatric patients undergoing heart surgery].
BACKGROUND
Procalcitonin is a diagnostic marker useful to discern infections and non-infectious complications in heart surgeries. The aim is to describe risk factors related to nosocomial pneumonia and the predictive value of serum procalcitonin in pediatric patients undergoing heart surgery.


METHODS
During a year a nested case-control study was carried out in a third level hospital. All patients undergoing open-heart surgery were followed and clinical data searching for pneumonia were registered every day. Blood samples for determination of procalcitonin were taken 48 hours after surgery. Those patients who developed pneumonia based on CDC clinical criteria were defined as cases; and controls were those patients who did not developed pneumonia.


RESULTS
188 patients underwent heart surgery (15 % developed pneumonia). Ninety-seven patients were submitted to open-heart surgery: 24 cases and 73 controls. Seventy-eight % of cases developed pneumonia between second and fifth day after surgery. The average time of surgery, extracorporial bypass, aortic cross-clamp, and mechanical ventilation were greater in control patients. The frequency of open sternotomy, reintubation, and surgical wound infections was greater in case patients.


CONCLUSIONS
Some of the events related to heart surgery and their subsequent management are associated significantly to the development of hospital-acquired pneumonia.
Servicio de Infectología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. guillermo.vazquezr@imss.gob.mx.
Rocío Elvira
RE
Fortanelli-Rodríguez
Alejandro
A
Gómez-Delgado
José Manuel
JM
Vera-Canelo
Miguel Ángel
MÁ
Alvarado-Diez
María Guadalupe
MG
Miranda-Novales
María Elena Yuriko
ME
Furuya
Fortino
F
Solórzano-Santos
José Guillermo
JG
Vázquez-Rosales
D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood; D006348:Cardiac Surgical Procedures; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D011014:Pneumonia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors
D015415:Biomarkers; D002116:Calcitonin
Pediatrics; Procalcitonin; Risk factors; Thoracic surgery