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Risk factors tied to pneumonia following CABG.

SAN DIEGO -- Prolonged mechanical ventilation, chronic obstructive pulmonary disease, late chest tube removal, and prolonged anesthetic time are risk factors for the development of pneumonia after coronary artery bypass surgery, Ruth Divinagracia, M.D., reported in a poster session at the 100th International Conference of the American Thoracic Society.

"In elective CABG cases, you have to work closely with your surgeons to minimize the avoidable risks, [including] removing the chest tubes as early as possible," Dr. Divinagracia said in a later interview. Also, "try to make your patients stop smoking, since this is the biggest risk for COPD."

She and her associates prospectively studied 83 patients who underwent CABG at St. Luke's Medical Center, Quezon City, the Philippines, in June 2003. They collected data on demographics, cardiac function, and coexisting medical conditions.

Of the 83 patients, 18 (22%) developed postoperative pneumonia according to criteria established by the Centers for Disease Control and Prevention. An increased risk of post-CABG pneumonia was associated with mechanical ventilator use beyond 12 hours (odds ratio [OR] 18.78), the presence or previous diagnosis of COPD (OR 14.14), chest tube in place beyond 48 hours (OR 6.32), and total anesthesia time greater than 4 hours (OR 4.59).

Age, sex, body mass index, smoking history, alcohol use, type 2 diabetes, renal disease, ejection fraction, cross-clamping, and bypass time were not associated with an increased risk of post-CABG pneumonia, noted Dr. Divinagracia, a pulmonologist and chief of critical care services at St. Luke's Medical Center.
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Title Annotation:Pulmonary Medicine; coronary artery bypass surgery
Author:Brunk, Doug
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1U9CA
Date:Jul 1, 2005
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