Analysis of risk factors and prevention strategies for pulmonary infection after heart valve surgery

LAI Xiao-gang; ZHAO Ke-yan; WANG Yang; LI Bao-yin

doi:10.16048/j.issn.2095-5561.2023.06.03

Abstract：Objective To analyze the pathogen distribution,risk factors and prevention strategies for pulmonary infection after heart valve surgery.Methods A total of 436 patients with heart valve replacement or repair surgery from July 2020 to February 2021 were retrospectively analyzed and divided into infection group(n =41)and non-infection group(n =395)according to the occurrence of pulmonary infection after heart valve surgery.Univariate and multivariate Logistic regression analysis were used to identify the risk fac-tors.Results There were 41 cases(9.4%)postoperative pulmonary infection.Totally 52 pathogenic strains were isolated,including 14 Gram-positive bacteria,37 Gram-negative bacteria and 1 fungus.The risk factors of postoperative pulmonary infection included age,smoking history,diabetes,renal dysfunction,preoperative cardiac function grade,cardiopulmonary bypass time,aortic blockade time,blood transfusion and mechanical ventilation time(P<0.05).Multivariate Logistic regression showed that renal insufficiency(OR = 2.707,P =0.001),preoperative poor cardiac function(OR = 1.466,P = 0.006),cardiopulmonary bypass time≥140 min(OR = 1.784,P =0.004),blood transfusion(OR =2.587,P =0.001),mechanical ventilation time≥48 h(OR =3.740,P =0.001)were in-dependent predictors of pulmonary infection after heart valve surgery.Conclusion The incidence of pulmonary infection after heart valve is high and main pathogens are Gram-negative bacteria.Renal insufficiency,preoperative poor cardiac function,cardiopulmonary bypass time,blood transfusion and mechanical ventilation time are independent risk factors for postoperative pulmonary infection,and clinical measures should be taken to reduce the risks for pulmonary infection after heart valve surgery and improve the prognosis.