Abstract:

Objective To investigate the effect of pre-operative oral preparation on incidence of ventilator-associated pneumonia (VAP) after cardiopulmonary bypass surgery in elderly patients. Methods Ninety-five patients (≥65 years old) undergoing cardiopulmonary bypass surgery were randomly divided into experiment group (n=48) and control group (n=47). For experiment group, besides conventional preoperative preparation, gargle mouthwash was used after three meals and before sleep on the day before surgery day and before surgery on the surgery day. Besides conventional preoperative preparation, no oral preparation was performed in control group. Tracheal intubation was conducted during anesthesia, oropharyngeal swab samples and sputum samples were collected before intubation and after intubation, and bacteria culture and identification were carried out. The incidences of  VAP after operation were compared between two groups. Results The oropharyngeal infection rate in experiment group was significantly lower than that in control group in oropharyngeal swab culture and sputum culture (P<0.05). The incidences of early-onset VAP and total VAP in experiment group were significantly lower than those in control group (P<0.05), while there was no significant difference in the incidence of late-onset VAP between two groups (P>0.05). Conclusion Pre-operative oral preparation can decrease the incidence of early-onset VAP in elderly patients undergoing cardiopulmonary bypass surgery.

Key words: elderly, cardiopulmonary bypass, surgery, oral preparation, respiratory tract infection