Clinical Impact of Postoperative Pneumonia on Ventilatory Dependency and ICU Utilization Following Adult Cardiac Surgery: Preliminary Findings From a Single-Center Observational Cohort

TL;DR

Postoperative pneumonia after heart surgery is common and leads to longer ventilation and ICU stays, highlighting the need for better prevention strategies.

Contribution

This study identifies clinical associations of postoperative pneumonia in cardiac surgery patients and emphasizes the need for targeted prevention strategies.

Findings

Postoperative pneumonia occurred in 22% of patients following cardiac surgery.

Pneumonia patients had significantly longer ICU stays and higher rates of prolonged ventilation and reintubation.

Cardiopulmonary bypass duration and diabetes were more common in patients who developed pneumonia.

Abstract

Background

Postoperative pneumonia remains a frequent and clinically consequential complication following adult cardiac surgery with cardiopulmonary bypass (CPB), contributing to prolonged ventilatory dependency and increased intensive care resource utilization. Identification of perioperative determinants may inform targeted prevention strategies.

Methods

We conducted a single-center retrospective observational cohort study including 50 consecutive adults undergoing cardiac surgery with CPB between January 2022 and December 2023. Postoperative pneumonia occurring within seven postoperative days was defined using combined clinical, radiologic, and microbiological criteria. Baseline characteristics, intraoperative variables, and early postoperative outcomes were compared between patients with and without pneumonia.

Results

Postoperative pneumonia developed in 11 of 50 patients (22%). Patients with pneumonia more frequently required prolonged mechanical ventilation (>24 hours) compared with those without pneumonia (64% vs 23%) and had higher reintubation rates (27% vs 5%). Intensive care unit length of stay was substantially longer among pneumonia patients (mean±SD, 7.8±3.1 vs 3.9±1.7 days). Cardiopulmonary bypass duration was longer, and diabetes mellitus was more prevalent in patients who developed pneumonia.

Conclusions

In this real-world cohort, postoperative pneumonia was common and consistently associated with sustained ventilatory dependence and increased ICU utilization. These findings underscore the clinical and resource burden of postoperative pulmonary complications and support risk-stratified perioperative strategies emphasizing early extubation readiness, pulmonary-protective management, and structured postoperative surveillance.

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