Clinical disease features and ventilator associated pneumonia after cardiac surgery：a Meta-analysis

WANG Shu-hong; CHEN Xiao; YANG Tu-bao; WEI Jie

doi:10.3969/j.issn.1674-4055.2016.11.05

Abstract：Objective To review comprehensively the correlation between clinical disease features and ventilator associated pneumonia (VAP) after cardiac surgery.Methods The databases of CNKI, WanFang Database, VIP Database, CBM, PubMed and EMbase were retrieved from the establishment time to Aug. 2016 for collecting relative study literature, and references were retrieved manually. The data from the literature was systematically reviewed by using RevMan 5.3 software and Stata12.0 software.Results There were totally 10 pieces of study literature included, and among them 9 were case controlled studies and 1 was cohort study. The objects of study were accumulatively 946, and among them 473 in case group and 473 in control group. There were 8 risk factors (WMD orOR and 95%CI) included and they were time of cardiopulmonary bypass (CPB,WMD=23.18, 95%CI: 18.00~28.36,P<0.001,I2=26%), postoperative PaO2/FiO2 (WMD=-87.45, 95%CI: -104.40~-70.50, P<0.001,I2=0%), mechanical ventilation (MV,SMD=1.19, 95%CI: 1.02~1.36,P<0.001,I2=0%), tracheotomy (OR=5.64, 95%CI: 3.31~9.61,P<0.001,I2=0%), aortic cross clamp time (WMD=6.4, 95%CI:2.08~10.73, P=0.004,I2=47%), low cardiac output syndrome (OR=2.82, 95%CI: 1.76~4.52,P<0.001,I2=0%) and stay time in ICU (WMD=3.43, 95%CI: 2.92~3.94,P<0.001,I2=24%), and differences all had statistical significance (P<0.05). Conclusion The risk factors related to VAP after cardiac surgery include longer CPB time, lower PaO2/FiO2, longer MV time, tracheotomy, longer aortic cross clamp time, low cardiac output syndrome and longer stay time in ICU in patients with heart disease. It is needed to further study that re-intubation is relative risk factor of VAP or not.