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心血管手术后肺炎:发病率、危险因素及干预措施

Pneumonia After Cardiovascular Surgery: Incidence, Risk Factors and Interventions.

作者信息

Wang Dashuai, Lu Yang, Sun Manda, Huang Xiaofan, Du Xinling, Jiao Zhouyang, Sun Fuqiang, Xie Fei

机构信息

Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Cardiovasc Med. 2022 Jun 30;9:911878. doi: 10.3389/fcvm.2022.911878. eCollection 2022.

Abstract

Postoperative pneumonia (POP) is prevalent in patients undergoing cardiovascular surgery, associated with poor clinical outcomes, prolonged hospital stay and increased medical costs. This article aims to clarify the incidence, risk factors, and interventions for POP after cardiovascular surgery. A comprehensive literature search was performed to identify previous reports involving POP after cardiovascular surgery. Current situation, predictors and preventive measures on the development of POP were collected and summarized. Many studies showed that POP was prevalent in various cardiovascular surgical types, and predictors varied in different studies, including advanced age, smoking, chronic lung disease, chronic kidney disease, cardiac surgery history, cardiac function, anemia, body mass index, diabetes mellitus, surgical types, cardiopulmonary bypass time, blood transfusion, duration of mechanical ventilation, repeated endotracheal intubation, and some other risk factors. At the same time, several targeted interventions have been widely reported to be effective to reduce the risk of POP and improve prognosis, including preoperative respiratory physiotherapy, oral care and subglottic secretion drainage. Through the review of the current status, risk factors and intervention measures, this article may play an important role in clinical prevention and treatment of POP after cardiovascular surgery.

摘要

术后肺炎(POP)在接受心血管手术的患者中很常见,与不良临床结局、住院时间延长和医疗费用增加相关。本文旨在阐明心血管手术后POP的发生率、危险因素及干预措施。进行了全面的文献检索,以识别先前涉及心血管手术后POP的报告。收集并总结了POP发生的现状、预测因素和预防措施。许多研究表明,POP在各种心血管手术类型中都很常见,不同研究中的预测因素各不相同,包括高龄、吸烟、慢性肺病、慢性肾病、心脏手术史、心功能、贫血、体重指数、糖尿病、手术类型、体外循环时间、输血、机械通气时间、反复气管插管以及其他一些危险因素。同时,有几项针对性干预措施已被广泛报道可有效降低POP风险并改善预后,包括术前呼吸物理治疗、口腔护理和声门下分泌物引流。通过对现状、危险因素和干预措施的综述,本文可能在心血管手术后POP的临床防治中发挥重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f903/9280273/bd8f36039b69/fcvm-09-911878-g0001.jpg

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