Original ArticlesVentilator-associated pneumonia: Incidence, risk factors, outcome, and microbiology*
Section snippets
Materials and methods
Approval of the institutional review board and informed consent from the patient were obtained for this prospective study conducted at Escorts Heart Institute and Research Centre between July 27, 2001, and October 31, 2001, to determine the incidence, risk factors, outcome, and pathogens of VAP in the cardiac surgical ICU. During this period, 952 adult patients who were undergoing cardiac operations and were admitted to the ICU on IPPV were included in this prospective study. They consisted of
Results
Of 952 patients in the study, 25 (2.6%) had VAP. The mean interval between admission to the ICU and the diagnosis of VAP was 4.5 ± 2.8 days. The median interval was 4 days. More than 90% of VAP cases occurred within 10 days of admission to the ICU.
Table 1 shows the results from the univariate analysis for 8 variables that were not significantly associated with VAP.Variable VAP (n = 25) Non-VAP (n = 927) p Value Age (y) 59.7 ± 12.7 56.5 ± 10.7 NS
Discussion
The authors investigated the incidence, risk factors, outcome, and pathogens of VAP in the cardiac surgical ICU. The estimated prevalence of nosocomial pneumonia in intensive care units ranges from 10% to 65% with mortality rates of 13% to 55%.1 Nosocomial pneumonia was diagnosed in 25 (2.6%) of the 952 patients in this study. The incidence of 2.6% in cardiothoracic patients is comparable to that reported in another study.6 The supine position of mechanically ventilated patients increases the
Acknowledgements
The authors thank S. Shekhawat for statistical analysis and R. Mathew for secretarial assistance.
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Address reprint requests to Yatin Mehta, MD, DNB, FRCA, FAMS, Department of Anaesthesiology, Escorts Heart Institute and Research Centre, New Delhi 110 025, India. E-mail: [email protected]