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荷兰心脏手术后儿童呼吸机相关性肺炎。

Ventilator-associated pneumonia in children after cardiac surgery in The Netherlands.

机构信息

Pediatric Intensive Care Unit, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.

出版信息

Intensive Care Med. 2011 Oct;37(10):1656-63. doi: 10.1007/s00134-011-2349-3. Epub 2011 Aug 30.

Abstract

PURPOSE

We conducted a retrospective cohort study in an academic tertiary care center to characterize ventilator-associated pneumonia (VAP) in pediatric patients after cardiac surgery in The Netherlands.

METHODS

All patients following cardiac surgery and mechanically ventilated for ≥24 h were included. The primary outcome was development of VAP. Secondary outcomes were duration of mechanical ventilation and length of ICU stay.

RESULTS

A total of 125 patients were enrolled. Their mean age was 16.5 months. The rate of VAP was 17.1/1,000 mechanical ventilation days. Frequently found organisms were Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Pseudomonas aeruginosa. Patients with VAP had longer duration of ventilation and longer ICU stay. Risk factors associated with the development of VAP were a PRISM III score of ≥10 and transfusion of fresh frozen plasma.

CONCLUSION

The mean VAP rate in this population is higher than that reported in general pediatric ICU populations. Children with VAP had a prolonged need for mechanical ventilation and a longer ICU stay.

摘要

目的

我们在荷兰的一家学术性三级护理中心进行了一项回顾性队列研究,以描述心脏手术后儿科患者呼吸机相关性肺炎(VAP)的特征。

方法

所有接受心脏手术后机械通气时间≥24 小时的患者均被纳入研究。主要结局是发生 VAP。次要结局是机械通气时间和 ICU 住院时间。

结果

共纳入 125 例患者,平均年龄为 16.5 个月。VAP 的发生率为 17.1/1000 机械通气日。常见的病原体为流感嗜血杆菌、卡他莫拉菌、金黄色葡萄球菌和铜绿假单胞菌。发生 VAP 的患者机械通气时间和 ICU 住院时间更长。与 VAP 发生相关的危险因素为 PRISM III 评分≥10 和输注新鲜冷冻血浆。

结论

该人群的 VAP 发生率高于一般儿科 ICU 人群报告的发生率。发生 VAP 的患儿需要更长时间的机械通气和 ICU 住院时间。

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