Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients
Ventilator-associated pneumonia is a frequent complication in intensive care surgical patients, particularly those with high severity scores on admission. We studied the incidence and clinical outcome of ventilator-associated pneumonia among patients undergoing major general surgery procedures and t...
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Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
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doaj-24f4848a19e3486e90a5ff6f77613e6b2020-11-24T22:22:57ZengSestre Milosrdnice University hospital, Institute of Clinical Medical Research Acta Clinica Croatica0353-94661333-94512016-01-0155.3.360369Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patientsKatarina Tomulić Brusich0Ivana Acan1Nataša Višković Filipčić2Department of Anesthesiology and Intensive Care, Merkur University Hospital, Zagreb, CroatiaDepartment of Anesthesiology and Intensive Care, Merkur University Hospital, Zagreb, CroatiaDepartment of Anesthesiology and Intensive Care, Merkur University Hospital, Zagreb, CroatiaVentilator-associated pneumonia is a frequent complication in intensive care surgical patients, particularly those with high severity scores on admission. We studied the incidence and clinical outcome of ventilator-associated pneumonia among patients undergoing major general surgery procedures and those undergoing cadaveric liver transplantation in our hospital. Patients with the intensive care unit stay longer than four days having undergone surgery or transplantation and mechanically ventilated for more than 48 hours were included in the study. Ventilator-associated pneumonia diagnosis was based on a combination of radiological signs (progressive infiltrate on chest radiograph), clinical signs (fever >38.3 °C, leukocytes >12×109/mL) and microbiological data (positive culture from tracheal aspiration >105 or bronchoalveolar lavage >104 colonies/mL). Medical records of 1037 patients were reviewed and 157 patients were found to have been mechanically ventilated for more than 48 hours: 62 transplanted and 95 non-transplanted. Only 39 (24.84%) patients matched the criteria for ventilator-associated pneumonia. There were no differences in sex, age, duration of mechanical ventilation, length of stay or outcome between the two groups. However, the main difference was the mean severity score on admission (Simplified Acute Physiology Score II) which was higher among non-transplant patients (42±16 vs. 31±9; p=0.03). Gram-negative bacteria were the leading causative agents (82.03%) and were multidrug-resistant. In the intensive care surgical population, transplantation per se does not seem to increase patient risk for either ventilator-associated pneumonia acquisition or worse outcomes.http://hrcak.srce.hr/file/254319Pneumonia, ventilator-associatedRespiration, artificialLiver transplantationOrgan dysfunction scores |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Katarina Tomulić Brusich Ivana Acan Nataša Višković Filipčić |
spellingShingle |
Katarina Tomulić Brusich Ivana Acan Nataša Višković Filipčić Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients Acta Clinica Croatica Pneumonia, ventilator-associated Respiration, artificial Liver transplantation Organ dysfunction scores |
author_facet |
Katarina Tomulić Brusich Ivana Acan Nataša Višković Filipčić |
author_sort |
Katarina Tomulić Brusich |
title |
Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients |
title_short |
Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients |
title_full |
Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients |
title_fullStr |
Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients |
title_full_unstemmed |
Ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients |
title_sort |
ventilator-associated pneumonia: comparing cadaveric liver transplant and non-transplant surgical patients |
publisher |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research |
series |
Acta Clinica Croatica |
issn |
0353-9466 1333-9451 |
publishDate |
2016-01-01 |
description |
Ventilator-associated pneumonia is a frequent complication in intensive care surgical patients, particularly those with high severity scores on admission. We studied the incidence and clinical outcome of ventilator-associated pneumonia among patients undergoing major general surgery procedures and those undergoing cadaveric liver transplantation in our hospital. Patients with the intensive care unit stay longer than four days having undergone surgery or transplantation and mechanically ventilated for more than 48 hours were included in the study. Ventilator-associated pneumonia diagnosis was based on a combination of radiological signs (progressive infiltrate on chest radiograph), clinical signs (fever >38.3 °C, leukocytes >12×109/mL) and microbiological data (positive culture from tracheal aspiration >105 or bronchoalveolar lavage >104 colonies/mL). Medical records of 1037 patients were reviewed and 157 patients were found to have been mechanically ventilated for
more than 48 hours: 62 transplanted and 95 non-transplanted. Only 39 (24.84%) patients matched the criteria for ventilator-associated pneumonia. There were no differences in sex, age, duration of mechanical ventilation, length of stay or outcome between the two groups. However, the main difference was the mean severity score on admission (Simplified Acute Physiology Score II) which was higher among non-transplant patients (42±16 vs. 31±9; p=0.03). Gram-negative bacteria were the leading causative agents (82.03%) and were multidrug-resistant. In the intensive care surgical population, transplantation per se does not seem to increase patient risk for either ventilator-associated pneumonia acquisition or worse outcomes. |
topic |
Pneumonia, ventilator-associated Respiration, artificial Liver transplantation Organ dysfunction scores |
url |
http://hrcak.srce.hr/file/254319 |
work_keys_str_mv |
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