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June 2010

Ventilator-Associated Pneumonia and Septic Shock in Emergency Colorectal Procedures in Elderly Patients—Reply

Author Affiliations

Author Affiliations: Department of Surgery (Drs McGillicuddy and Longo), and Section of Trauma, Surgical Critical Care, and Surgical Emergencies (Drs Schuster and Davis), Yale University School of Medicine, New Haven, Connecticut.

Arch Surg. 2010;145(6):602-603. doi:10.1001/archsurg.2010.74

In reply

We thank Ñamendys-Silva and colleagues for their inquiry regarding ICU length of stay and mechanical ventilation. Overall, 156 patients (53.4%) required postoperative ICU care (median ICU length of stay, 4 days). One hundred fifteen patients (39.3%) were underwent mechanical ventilation postoperatively (median time of mechanical ventilation, 5 days). Twenty-five percent of patients in this study developed pneumonia, and although there was a clear correlation between length of mechanical ventilation and development of pneumonia, in a minority of patients it was difficult to clinically distinguish VAP from an aspiration event.

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