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We report the incidence of, and risk factors for, ventilator-associated pneumonia (VAP) at the King Fahad National Guard Hospital. Of the 202 patients studied, 41 (25.2%) had VAP. The incidence density was 16.8/1,000 person-days of ventilation. Variables significantly associated with VAP were serious injury from motor-vehicle accident, enteral feeding, and length of ventilation. The avoidance of unnecessary enteral nutrition could help to reduce VAP.

H-CSF for treatment of neutropenia in patients admitted to the ICU did not accelerate neutrophil recovery or improve survival.

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Aims: To study the relationship between myocardial release of cTnI and myocardial cell death as assessed by the amount of apoptosis and necrosis after cardiac surgery. Methods: Eighteen young pigs were operated on with standardized cardiopulmonary bypass (CPB). Release of cTnI in the cardiac lymph (CL), coronary sinus (CS), and arterial blood (A) was related to postoperative myocardial cell death by both necrosis and apoptosis. Apoptotic cells were detected by a TUNEL detection kit. Necrotic cells were counted by light microscopy. Results: In all animals, cTnI was significantly released and reached peak values observed simultaneously in A (cTnI, 20.1±2.6 ng/ml) (mean ±SEM), CS (19.5±3.2 ng/ml) and CL (5202±2500 ng/ml). Percentage of total myocardial cell death was 3.1±0.5%, including 1.2±0.35% necrosis and 1.9±0.5% apoptosis. cTnI release during and after CPB did not correlate with the degree of myocardial apoptosis or necrosis. Conclusion: Cardiac operations with CPB are related to myocardial cell damage including myocardial cell death due to both necrosis and apoptosis. As the loss of cTnI is not related to the amount of cell death, our results suggest that increased cardiac myocyte membrane permeability more than cell death is responsible for intraoperative and postoperative cTnI release.