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After Heart Surgery, Risk Factors Identified For Pneumonia

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Ventilator-associated pneumonia (VAP) is the leading cause of nosocomial infection in patients undergoing major affection surgery. An international study of 25 hospitals from 8 European countries, published in BioMed Central's open access chronicle Critical Care, has confirmed the measure of danger posed by VAP and identified the main risk factors.
Javier Hortal, from the Infirmary Habitual Universitario Gregorio Mara√ √ n, worked with the European Announce Chain on Nosocomial Infections (ESGNI) and the European Workgroup of Cardiothoracic Intensivists (EWCI) to transact out a prospective scan of 971 patients undergoing higher heart surgery. They construct that 4.4% acquired some form of nosocomial infection and VAP accounted for nearly half of these (2.1%). According to Hortal, "The crude mortality ratio of patients with VAP in our glance at was found to be 35%, this is significantly more than the mortality rate of 2.3% seen in patients who avoided VAP. The overall mortality rate for VAP in patients undergoing MHS may be as aerial as 16-57%, on the other hand innumerable critically ill patients with VAP die for of their underlying disease rather than of pneumonia, which makes analysis difficult."
The authors form that, apart from the bigness of time spent on mechanical ventilation, other risk factors for the buildup of VAP included transfusion requirements, type of surgery and the necessitate for re-intervention for haemorrhage or cardiac tamponade in the prompt postoperative period. Hortal said, "Most unfortunately, the majority of the variables that significantly predict VAP are not amenable to intervention."
The authors reccomend that anticipative or pre-emptive antimicrobial therapy should be explored as one of the meagre potential interventions to avoid VAP in patients remaining under mechanical ventilation for more than 48 hours.
Ventilator-associated pneumonia in patients undergoing major passion surgery: an incidence study in Europe
Javier Hortal, Patricia Mu√ oz, Gregorio P Cuerpo, H√ ctor Litvan, Peter M Rosseel, Emilio Bouza, the European Discover Cartel on Nosocomial Infections and the European Workgroup of Cardiothoracic Intensivists
Critical Care (in press)
Article available at journal website:
Graeme Baldwin
BioMed Central
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