Ventilator-associated pneumonia after heart surgery: A prospective analysis and the value of surveillance*

Abstract

Patients undergoing heart surgery have a high frequency of VAP. VAP is associated with a poor prognosis. In this study, surveillance cultures failed as an anticipative diagnostic method.

Ventilator-associated pneumonia is an important risk factor for mortality after major cardiac surgery

“…Overall in-hospital mortality in the study population was 6.9%, with a mortality rate in patients with VAP of 45.7% vs 2.8% in patients without VAP (P ≤ .001). However, in a recent European multicenter study [40], a VAP incidence rate of 2.2%, lower than that found in our and other studies [3,38,39], was identified.…”

“…Mortality in patients with VAP is a controversial subject concerning patients admitted to the ICU because the target population is severely ill and the level of associated mortality is high. Several studies have attempted to clarify the issue [3,15,16]. Bueno-Cavanillas et al [15] found that critically ill patients with a nosocomial infection, mainly bacteremia and pneumonia, have a higher rate of mortality.…”

“…Thirty (5.0%) patients died during hospitalization after cardiac surgery, and the mortality rate of patients with VAP was 23.7%. Bouza et al [3] analyzed 356 patients and found a frequency of VAP of 7.8% with an overall mortality of 7.3%. Death was significantly more frequent in patients with VAP (57.1%) than in any other group.…”

“…At the same time, inhospital patients are also at risk for multiple postoperative events (eg, myocardial infarction [MI], congestive heart failure, acute renal failure, strokes) [1][2][3][4]16,18,19]. These comorbidities complicate the evaluation of the impact of VAP on mortality [17].…”

“…The prevalence of VAP is estimated to be 7.8% to 21.6% [1][2][3] and is associated with prolonged hospitalization [4,5], increased health care costs [6], and a 15% to 45% attributable mortality [7].…”