Nosocomial infection after off-pump coronary artery bypass grafting is an uncommon but potentially life-threatening complication. The identification of independent risk factors, including arterial hypertension, associated with development of postoperative infection may help in the development of clinical strategies for the prevention, early diagnosis, and treatment of these infections.

The role of positive end-expiratory pressure (PEEP) in the postoperative course of cardiac surgery patients remains questionable. In this prospective study, we examined the effect of different levels of PEEP on arterial oxygenation, SvO2 and PvO2 values, and on haemodynamic indices, during the early postoperative period in cardiac surgery patients. Upon transfer to the ICU, 67 adult patients with normal preoperative respiratory status were randomly assigned to receive zero PEEP (Group A), 5 cmH2O (Group B), or 10 cmH2O PEEP (Group C) during mechanical ventilatory support. PaO2/FIO2 ratio, mixed venous PvO2 and SvO2, and cardiac index, were measured 30 min, 4 h and 8 h after application of mechanical ventilation in the ICU, just prior to extubation, half an hour after extubation, and 4 h post-extubation. We found no statistically significant differences (P = n.s.) in arterial oxygenation expressed by PaO2/FIO2 ratio, SvO2 and PvO2 values, and in cardiac index among the three groups at any study interval. We conclude that low levels of PEEP have no advantage over zero PEEP in improving gas exchange in the early postoperative course of patients following open heart surgery.

All-cause in-hospital mortality was higher in the oldest-old group than in younger patients, but the mortality of this cohort of patients did not seem to reach a figure that would make physicians, relatives, and healthcare administrators decide against ICU care in this population.