Skip to main content
Top
Published in: Intensive Care Medicine 9/2009

Open Access 01-09-2009 | Editorial

Prevention of ventilator-associated pneumonia after cardiac surgery: prepare and defend!

Authors: Patrique Segers, Bas A. de Mol

Published in: Intensive Care Medicine | Issue 9/2009

Login to get access

Excerpt

To expect that all patients undergoing major surgery can have unflawed outcomes is not realistic. Surgery is performed by humans on humans and always will have complications such as nosocomial infections. Despite the progress in surgery and anaesthesia, the risk of developing nosocomial infections remains a real threat as more patients of greater age and with more co-morbidity are to be operated on [1]. …
Literature
2.
go back to reference Vincent JL, Bihari DJ, Suter PM (1995) The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee. JAMA 274:639–644PubMedCrossRef Vincent JL, Bihari DJ, Suter PM (1995) The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee. JAMA 274:639–644PubMedCrossRef
3.
go back to reference Rello J, Ollendorf DA, Oster G (2002) Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 122:2115–2121PubMedCrossRef Rello J, Ollendorf DA, Oster G (2002) Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 122:2115–2121PubMedCrossRef
4.
go back to reference Arabi Y, Al-Shirawi N, Memish Z (2008) Ventilator-associated pneumonia in adults in developing countries: a systematic review. Int J Infect Dis 12:505–512PubMedCrossRef Arabi Y, Al-Shirawi N, Memish Z (2008) Ventilator-associated pneumonia in adults in developing countries: a systematic review. Int J Infect Dis 12:505–512PubMedCrossRef
5.
go back to reference Kluytmans JA, Mouton JW, Maat AP, Manders MA, Michel MF, Wagenvoort JH (1994) Surveillance of postoperative infections in thoracic surgery. J Hosp Infect 27:139–147PubMedCrossRef Kluytmans JA, Mouton JW, Maat AP, Manders MA, Michel MF, Wagenvoort JH (1994) Surveillance of postoperative infections in thoracic surgery. J Hosp Infect 27:139–147PubMedCrossRef
6.
go back to reference Kollef MH, Sharpless L, Vlasnik J, Pasque C, Murphy D, Fraser VJ (1997) The impact of nosocomial infections on patient outcomes following cardiac surgery. Chest 112:666–675PubMedCrossRef Kollef MH, Sharpless L, Vlasnik J, Pasque C, Murphy D, Fraser VJ (1997) The impact of nosocomial infections on patient outcomes following cardiac surgery. Chest 112:666–675PubMedCrossRef
7.
go back to reference Anonymous (2004) National nosocomial infections surveillance (NNIS) system report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 32:470–485 Anonymous (2004) National nosocomial infections surveillance (NNIS) system report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 32:470–485
8.
go back to reference Hortal J, Giannella M, Perez MJ, Barrio JM, Desco M, Bouza E, Muñoz P (2009) Incidence and risk factors for Ventilator Associated Pneumonia after Major Heart Surgery. Intensive Care Medicine Hortal J, Giannella M, Perez MJ, Barrio JM, Desco M, Bouza E, Muñoz P (2009) Incidence and risk factors for Ventilator Associated Pneumonia after Major Heart Surgery. Intensive Care Medicine
9.
go back to reference Levy JH, Tanaka Kasteiner ME (2005) Evaluation and management of bleeding during cardiac surgery. Curr Hematol Rep 4:368–372PubMed Levy JH, Tanaka Kasteiner ME (2005) Evaluation and management of bleeding during cardiac surgery. Curr Hematol Rep 4:368–372PubMed
10.
go back to reference Hulzebos EHJ, Helders PJM, Favié NJ (2006) Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA 296:1851–1857PubMedCrossRef Hulzebos EHJ, Helders PJM, Favié NJ (2006) Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA 296:1851–1857PubMedCrossRef
11.
12.
go back to reference Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Hoc Espen Working Group (2003) Nutritional risk screening (NRS 2002): a new method based on analysis of controlled clinical trials. Clin Nutr 22:321–336PubMedCrossRef Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Hoc Espen Working Group (2003) Nutritional risk screening (NRS 2002): a new method based on analysis of controlled clinical trials. Clin Nutr 22:321–336PubMedCrossRef
13.
go back to reference Kruizenga HM, van Tulder MW, Seidell JC, Ader HJ, Bokhorst-de Van, van der Schueren MAE (2005) Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients. Am J Clin Nutr 82:1082–1089PubMed Kruizenga HM, van Tulder MW, Seidell JC, Ader HJ, Bokhorst-de Van, van der Schueren MAE (2005) Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients. Am J Clin Nutr 82:1082–1089PubMed
14.
go back to reference Tepaske R, te Velthuis H, Oudemans-van Straaten HM, Heisterkamp SH, van Deventer SJH, Ince C, Eijsman L, Kesecioglu J (2001) Effect of preoperative oral immune-enhancing nutritional supplement on patients at high risk of infection after cardiac surgery: a randomized placebo-controlled trial. Lancet 358:696–701PubMedCrossRef Tepaske R, te Velthuis H, Oudemans-van Straaten HM, Heisterkamp SH, van Deventer SJH, Ince C, Eijsman L, Kesecioglu J (2001) Effect of preoperative oral immune-enhancing nutritional supplement on patients at high risk of infection after cardiac surgery: a randomized placebo-controlled trial. Lancet 358:696–701PubMedCrossRef
15.
go back to reference Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R (2004) CDC. Guidelines for preventing health-care-associated pneumonia, 2003. Recommendations of the CDC and the healthcare infection control practices advisory committee. MMWR 53 (No. RR–3) Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R (2004) CDC. Guidelines for preventing health-care-associated pneumonia, 2003. Recommendations of the CDC and the healthcare infection control practices advisory committee. MMWR 53 (No. RR–3)
16.
go back to reference Shorr AF, Kollef MH (2005) Ventilator-associated pneumonia: insights from recent clinical trials. Chest 128:583S–591SPubMedCrossRef Shorr AF, Kollef MH (2005) Ventilator-associated pneumonia: insights from recent clinical trials. Chest 128:583S–591SPubMedCrossRef
17.
go back to reference Bouza E, Pérez MJ, Muñoz P, Rincón C, Barrio JM, Hortal J (2008) Continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in the postoperative period of major heart surgery. Chest 134:898–900CrossRef Bouza E, Pérez MJ, Muñoz P, Rincón C, Barrio JM, Hortal J (2008) Continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in the postoperative period of major heart surgery. Chest 134:898–900CrossRef
18.
go back to reference de Smet AM, Kluytmans JA, Cooper BS, Mascini EM, Benus RF, van der Werf TS, van der Hoeven JG, Pickkers P, Bogaers-Hofman D, van der Meer NJ (2009) Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 360:20–31PubMedCrossRef de Smet AM, Kluytmans JA, Cooper BS, Mascini EM, Benus RF, van der Werf TS, van der Hoeven JG, Pickkers P, Bogaers-Hofman D, van der Meer NJ (2009) Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 360:20–31PubMedCrossRef
19.
go back to reference Kollef MH (2003) Selective digestive decontamination should not be routinely employed. Chest 123:464S–468SPubMedCrossRef Kollef MH (2003) Selective digestive decontamination should not be routinely employed. Chest 123:464S–468SPubMedCrossRef
20.
go back to reference Bonten MJ (2006) Selective digestive tract decontamination–will it prevent infection with multidrug-resistant Gram-negative pathogens but still be applicable in institutions where methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci are endemic? Clin Infect Dis 43:S70–S74PubMedCrossRef Bonten MJ (2006) Selective digestive tract decontamination–will it prevent infection with multidrug-resistant Gram-negative pathogens but still be applicable in institutions where methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci are endemic? Clin Infect Dis 43:S70–S74PubMedCrossRef
21.
go back to reference Segers P, Speekenbrink RGH, Ubbink DT, van Ogtrop ML, de Mol BA (2006) Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate. A randomized controlled trial. JAMA 296:2460–2466PubMedCrossRef Segers P, Speekenbrink RGH, Ubbink DT, van Ogtrop ML, de Mol BA (2006) Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate. A randomized controlled trial. JAMA 296:2460–2466PubMedCrossRef
22.
go back to reference Koeman M, van der Ven AJ, Hak E, Joore HC, Kaasjager K, de Smet AG, Ramsay G, Dormans TP, Aarts LP, de Bel EE (2006) Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia. Am J Respir Crit Care Med 173:1348–1355PubMedCrossRef Koeman M, van der Ven AJ, Hak E, Joore HC, Kaasjager K, de Smet AG, Ramsay G, Dormans TP, Aarts LP, de Bel EE (2006) Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia. Am J Respir Crit Care Med 173:1348–1355PubMedCrossRef
Metadata
Title
Prevention of ventilator-associated pneumonia after cardiac surgery: prepare and defend!
Authors
Patrique Segers
Bas A. de Mol
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 9/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-009-1522-4

Other articles of this Issue 9/2009

Intensive Care Medicine 9/2009 Go to the issue