Risk factors of ventilator-associated pneumonia in neonates after cardiac surgery with cardiopulmonary bypass

S. Khemio Arnes; L. Zgrzheblovska; L. Moshkivska; S. Boyko; I. Perepeka; Y. Truba; V. Lazoryshynetz

S. Khemio Arnes National M.M. Amosov Institute of Cardiovascular Surgery from National Academy of Medical Sciences of Ukraine (Kyiv)
L. Zgrzheblovska Shupyk National Medical Academy of Postgraduate Education (Kyiv)
L. Moshkivska National M.M. Amosov Institute of Cardiovascular Surgery from National Academy of Medical Sciences of Ukraine (Kyiv)
S. Boyko National M.M. Amosov Institute of Cardiovascular Surgery from National Academy of Medical Sciences of Ukraine (Kyiv)
I. Perepeka National M.M. Amosov Institute of Cardiovascular Surgery from National Academy of Medical Sciences of Ukraine (Kyiv)
Y. Truba National M.M. Amosov Institute of Cardiovascular Surgery from National Academy of Medical Sciences of Ukraine (Kyiv)
V. Lazoryshynetz National M.M. Amosov Institute of Cardiovascular Surgery from National Academy of Medical Sciences of Ukraine (Kyiv)

Keywords: ventilator-associated pneumonia, nosocomial infections, antibiotics, newborns, cardiac surgery, cardiopulmonary bypass, congenital heart disease

Abstract

Objective: identify the risk factors of ventilator-associated pneumonias in newborns after cardiac surgery with cardiopulmonary bypass.

Methods: 39 patients of neonatal age with congenital heart diseases who underwent cardiac surgery and who were on mechanical ventilation for more than 24 hours in the postoperative period were included in this study.

Results: during this investigation 39 patients were examined. The strains of microorganisms that most often cause ventilator-associated pneumonia in newborns have been found: Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus faecalis. Patients who are on artificial ventilation for more than 72 hours, and those who undergo surgery with a high level of complexity, are more likely to develop pneumonia.

Conclusions: Newborns after cardiac surgery with cardiopulmonary bypass with ventilator-associated pneumonia have a longer stay in the intensive care unit.

References

1. Bedside prediction rule for infections after pediatric cardiac surgery / Algra S., Driessen M., Schadenberg A. et al. // Intensive Care Med. – 2012. – Vol. 38. – P. 474–81.

2. The relationship between inflammatory activation and clinical outcome after infant cardiopulmonary bypass / Allan C., Newburger J., McGrath E. et al. // Anesthesia & Analgesia. – 2012. – Vol. 111. – P. 1244–51.

3. Infecciones asociadas a la atenciуn en salud en pacientes pediбtricos post-operados de cardiopatнas congйnitas / Barriga J., Cerda J., Abarca K. et al. // Revista Chilena de Infectologнa. – 2014. – Vol. 31 (1). – P. 16–20.

4. Actualizaciуn del Consenso “Neumonнa asociada a ventilaciуn mecбnica” Primera parte Aspectos diagnуsticos / Fica A., Cifuentes M., Hervй B. // Revista Chilena de Infectologнa. – 2012. – Vol. 28 (2). – P. 130–51.

5. Nosocomial infections in pediatric cardiovascular surgery patients: a 4-year survey / Grisaru-Soen G., Paret G., Yahav D. et al. // Pediatric Critical Care Medicine. – 2012. – Vol. 10. – P. 202–6.

6. Infecciуn nosocomial en postoperados de cirugнa cardнaca / Guardia M., Jordan I., Urrea M. // iAnestesiologнa Pediatrca. – 2012. – P. 69 (1). – 34–8.

7. Ventilator-associated pneumonia in children after cardiac surgery in The Netherlands / Roeleveld P. P., Guijt D., Kuijper E. J. et al. // Intensive Care Med. – 2012. – Vol. 37. – P. 1656–63.

8. Роль цитокінів у прогнозуванні післяопераційних ускладнень у дітей / Мошківська Л. В., Хеміо Арнес С. Г. та ін. // Вісник серцево-судинної хірургії. – 2016. – № 2. – С. 79–82.