Ventilator-associated pneumonia after pediatric cardiac surgery in southern Taiwan

Chia Wan Tang, Po Yen Liu, Yung Feng Huang, Jun Yen Pan, Susan Shin Jung Lee, Kai Sheng Hsieh, Yung Ching Liu, Luo Ping Ger

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background and purpose: To determine the frequency, risk factors, associated pathogens, and outcomes of ventilator-associated pneumonia (VAP) after pediatric cardiac surgery. Methods: This was a retrospective review of the medical records of patients younger than 18 years with congenital heart disease (CHD) who underwent cardiac surgery from January 2005 to December 2007. Patients were categorized into 2 groups: with and without VAP. Results: Of 100 patients, 13% acquired VAP. Most patients (85%) who developed VAP were infants younger than 1 year. Patients with complex CHD were more likely to develop VAP than patients with simple CHD (χ2 = 7.69; p <0.03). Two independent and modifiable risk factors were identified: prolonged use of mechanical ventilation (adjusted odds ratio [AOR], 15.196; 95% confidence interval [CI], 2.158-107.2) and prolonged use of a central venous catheter (AOR, 7.342; 95% CI, 1.054-51.140. The cardiopulmonary bypass time and duration of chest tube drainage were not risk factors. The development of VAP increased pediatric intensive care unit duration of stay (p <0.006), duration of hospital stay (p <0.001), and mortality rate (p <0.001). Pseudomonas aeruginosa end methicillin-resistant Staphylococcus aureus were the most common pathogens isolated from endotracheal aspirate. Conclusions: VAP is common after congenital heart surgery. Physicians must pay special attention to infants with complex CHD because they are at high risk for the development of VAP after congenital heart surgery. Shortening the duration of mechanical ventilation and central venous catheter placement are critical factors for reducing the risk for VAP.

Original languageEnglish
Pages (from-to)413-419
Number of pages7
JournalJournal of Microbiology, Immunology and Infection
Volume42
Issue number5
Publication statusPublished - Oct 2009
Externally publishedYes

Fingerprint

Ventilator-Associated Pneumonia
Taiwan
Thoracic Surgery
Pediatrics
Heart Diseases
Central Venous Catheters
Artificial Respiration
Odds Ratio
Confidence Intervals
Chest Tubes
Pediatric Intensive Care Units
Methicillin-Resistant Staphylococcus aureus
Cardiopulmonary Bypass
Pseudomonas aeruginosa
Medical Records
Drainage
Length of Stay
Physicians

Keywords

  • Intensive care units, pediatric
  • Pneumonia, ventilator associated
  • Thoracic surgery

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Infectious Diseases

Cite this

Tang, C. W., Liu, P. Y., Huang, Y. F., Pan, J. Y., Lee, S. S. J., Hsieh, K. S., ... Ger, L. P. (2009). Ventilator-associated pneumonia after pediatric cardiac surgery in southern Taiwan. Journal of Microbiology, Immunology and Infection, 42(5), 413-419.

Ventilator-associated pneumonia after pediatric cardiac surgery in southern Taiwan. / Tang, Chia Wan; Liu, Po Yen; Huang, Yung Feng; Pan, Jun Yen; Lee, Susan Shin Jung; Hsieh, Kai Sheng; Liu, Yung Ching; Ger, Luo Ping.

In: Journal of Microbiology, Immunology and Infection, Vol. 42, No. 5, 10.2009, p. 413-419.

Research output: Contribution to journalArticle

Tang, CW, Liu, PY, Huang, YF, Pan, JY, Lee, SSJ, Hsieh, KS, Liu, YC & Ger, LP 2009, 'Ventilator-associated pneumonia after pediatric cardiac surgery in southern Taiwan', Journal of Microbiology, Immunology and Infection, vol. 42, no. 5, pp. 413-419.
Tang, Chia Wan ; Liu, Po Yen ; Huang, Yung Feng ; Pan, Jun Yen ; Lee, Susan Shin Jung ; Hsieh, Kai Sheng ; Liu, Yung Ching ; Ger, Luo Ping. / Ventilator-associated pneumonia after pediatric cardiac surgery in southern Taiwan. In: Journal of Microbiology, Immunology and Infection. 2009 ; Vol. 42, No. 5. pp. 413-419.
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abstract = "Background and purpose: To determine the frequency, risk factors, associated pathogens, and outcomes of ventilator-associated pneumonia (VAP) after pediatric cardiac surgery. Methods: This was a retrospective review of the medical records of patients younger than 18 years with congenital heart disease (CHD) who underwent cardiac surgery from January 2005 to December 2007. Patients were categorized into 2 groups: with and without VAP. Results: Of 100 patients, 13{\%} acquired VAP. Most patients (85{\%}) who developed VAP were infants younger than 1 year. Patients with complex CHD were more likely to develop VAP than patients with simple CHD (χ2 = 7.69; p <0.03). Two independent and modifiable risk factors were identified: prolonged use of mechanical ventilation (adjusted odds ratio [AOR], 15.196; 95{\%} confidence interval [CI], 2.158-107.2) and prolonged use of a central venous catheter (AOR, 7.342; 95{\%} CI, 1.054-51.140. The cardiopulmonary bypass time and duration of chest tube drainage were not risk factors. The development of VAP increased pediatric intensive care unit duration of stay (p <0.006), duration of hospital stay (p <0.001), and mortality rate (p <0.001). Pseudomonas aeruginosa end methicillin-resistant Staphylococcus aureus were the most common pathogens isolated from endotracheal aspirate. Conclusions: VAP is common after congenital heart surgery. Physicians must pay special attention to infants with complex CHD because they are at high risk for the development of VAP after congenital heart surgery. Shortening the duration of mechanical ventilation and central venous catheter placement are critical factors for reducing the risk for VAP.",
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AU - Hsieh, Kai Sheng

AU - Liu, Yung Ching

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