Risk factors for ventilator-associated pneumonia following cardiac surgery

Hassoun-Kheir, Nasreen; Hussein, Khetam; Abboud, Zaher; Raderman, Yaniv; Abu-Hanna, Lana; Darawshe, Abed; Bolotin, Gil; Paul, Mical

doi:10.1016/j.jhin.2020.04.009

Cited by 18 publications

(11 citation statements)

References 29 publications

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“…Joseph et al suggested that a longer hospitalization time before VAP diagnosis is a risk factor for MDRO VAP infection [17]. Nasreen and colleagues showed that postoperative VAP in patients undergoing cardiac surgery is associated with higher mortality and longer hospital stays [7]. However, this is different from the results of our study.…”

Section: Discussioncontrasting

confidence: 94%

“…While undergoing cardiac surgery, multiple drug-resistant pathogens can lead to preoperative infections (e.g., endocarditis) or postoperative infections (including wound and device infections), affecting the prognosis of patients. Furthermore, studies have shown that postoperative VAP infection in patients after cardiac surgery is associated with multiple factors, including preoperative congestive heart failure, intraoperative red blood cell input volume, blood glucose levels and length of extracorporeal circulation [7]. Frequent postoperative invasive procedures can also lead to VAP infection in patients, such as aortic balloon counterpulsation and cardiac catheter placement [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for ventilator-associated pneumonia due to multi-drug resistant organisms after cardiac surgery in adults

Wang

et al. 2022

Preprint

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Background: Ventilator-associated pneumonia (VAP) is one of the most common intensive care unit (ICU)-acquired infections，which can cause multiple adverse events. Due to bacterial mutation and overuse of antimicrobial drugs, multidrug-resistant organisms (MDRO) have become an important group of VAP infections in postoperative cardiac patients. Therefore, the purpose of this study is to explore the risk factors for VAP with MDRO following cardiac surgery in adults. Methods: The clinical data of adult patients with VAP following cardiac surgery in the hospital from Jan 2017 to May 2021 were analyzed retrospectively, the patients were divided into the MDRO VAP group and the non-MDRO VAP group. Univariable and multivariable logistic regression analyses were performed for the risk factor for the patient with MDRO VAP. The species and drug sensitivity of pathogens isolated from the VAP patients were also analyzed. Results: A total of 61 VAP cases with 34 cases in the MDRO VAP group (55.7%) and 27 cases in the non-MDRO VAP group (44.3%) were involved in this study. Multivariable logistic regression analysis showed that the independent risk factors for the MDRO VAP included preoperative creatinine clearance rate (CCR) ≥86.6ml, intraoperative cardiopulmonary bypass (CPB) time≥151 mins, postoperative acute kidney injury (AKI) and nasal feeding. Gram-negative bacilli were the main pathogens in VAP patients (n=54, 90.0%), with the highest rate of Acinetobacter baumannii (n=24, 40.0%). Patients with MDRO VAP had significantly longer postoperative intensive care unit (ICU) duration and higher hospitalization costs than non-MDRO VAP patients, but there was no significant difference in the 28-day mortality rate between the two groups. Conclusion: Based on implementing measures to prevent VAP, clinicians should pay more attention to patients with kidney disease, intraoperative longer CPB time, and postoperative nasal feeding to avoid MDRO infections.

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Section: Discussioncontrasting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Risk factors for ventilator-associated pneumonia due to multi-drug resistant organisms after cardiac surgery in adults

Wang

et al. 2022

Preprint

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“…Nasal and oral cavity secretions accumulate above the cuff of the tracheal catheter and below the glottis in patients with cerebral hemorrhage in ICU receiving mechanical ventilation [ 15 , 16 ]. In patients with endotracheal intubation, opening oral cavity, and airway easily can cause pathogenic bacteria colonizing secretions that collect in the oropharynx.…”

Section: Discussionmentioning

confidence: 99%

Research on Effects of Oropharyngeal Aspiration on Incidence of Ventilator-Associated Pneumonia in Patients with Cerebral Hemorrhage in ICU

Guo

Nie

et al. 2022

Journal of Healthcare Engineering

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Cerebral hemorrhage is a kind of intracranial hemorrhage caused by nontraumatic vascular rupture of the cerebral parenchyma, which is a common cerebrovascular disease with a high disability rate and mortality. This study aimed to explore the effects of oropharyngeal aspiration in reducing ventilator-associated pneumonia in patients with cerebral hemorrhage in ICU. In this study, 96 patients with cerebral hemorrhage were selected as the subjects. They received surgical treatment, and then they were transferred into ICU of Fourth Affiliated Hospital of Harbin Medical University from December 2019 to March 2020. The patients were randomly divided into intervention group and control group, with 48 in each group. The intervention group received periodic oropharyngeal aspiration, while the control group received routine nursing measures. After the intervention, the incidence of ventilator-associated pneumonia and the positive rate of amylase α-trachea cannula specimens were recorded and compared between the two groups. After the intervention, the incidence of ventilator-associated pneumonia was 14.89% in the intervention group and 39.58% in the control group, with a statistically significant difference. And, the α-amylase positive rate, mechanical ventilation time, and ICU care duration of endotrachea cannula specimens in the intervention group were significantly lower than those in the control group. In conclusion, oropharyngeal aspiration can effectively reduce the incidence of ventilator-associated pneumonia after cerebral hemorrhage and shorten mechanical ventilation and ICU care duration. It promotes the rehabilitation of patients.

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“…It has also been suggested that the disease-causing microorganisms observed in respiratory secretions are mainly Gramnegative bacilli. In addition to the above, Escherichia coli with high drug resistance has also been observed (9,11,20,21).…”

Section: Etiologymentioning

confidence: 99%

A Literature Review on Hospital-Acquired Pneumonia, Community-Acquired Pneumonia, and Ventilator-Associated Pneumonia

et al. 2021

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: One of the most dangerous respiratory diseases is pneumonia, one of the ten leading causes of death globally. Hospital-acquired pneumonia (HAP) is a common infection in hospitals, which is the second most common nosocomial infection and causes inflammation parenchyma. In Community-acquired pneumonia (CAP), we have various risk factors, including age and gender, and also some specific risk factors. Ventilator-associated pneumonia (VAP) is one of the deadliest nosocomial infections. According to the Centers for Disease Control and Prevention, VAP is pneumonia that develops about 48 hours of an artificial airway. Bacterial, viral, parasitic, primordial, and other species can cause these diseases. We discuss bacterial factors. Our goal is to gather information about HAP, CAP, and VAP to give people specific information. In this study, these three issues have been examined together, but in similar studies, each of them has been examined separately, and our type of study will be more helpful in diagnosis and treatment.

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Risk factors for ventilator-associated pneumonia following cardiac surgery

Cited by 18 publications

References 29 publications

Risk factors for ventilator-associated pneumonia due to multi-drug resistant organisms after cardiac surgery in adults

Risk factors for ventilator-associated pneumonia due to multi-drug resistant organisms after cardiac surgery in adults

Research on Effects of Oropharyngeal Aspiration on Incidence of Ventilator-Associated Pneumonia in Patients with Cerebral Hemorrhage in ICU

A Literature Review on Hospital-Acquired Pneumonia, Community-Acquired Pneumonia, and Ventilator-Associated Pneumonia

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