Open Access

ARTICLE

Impact of a Multifaceted Prevention Program on Ventilator-Associated Pneumonia in a Surgical Pediatric Cardiac ICU

Xiaofeng Wang^1,#, Da Huo^2,3,#, Shuo Li^4,#, Wenlong Wang¹, Qian Zhang¹, Ya Gao⁵, Xu Wang^1,*
1 Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
2 Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control, Beijing, China
3 School of Public Health, Capital Medical University, Beijing, China
4 Department of Infection Control, Peking University First Hospital, Beijing, China
5 Department of Infection Control, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
* Corresponding Author: Xu Wang. Email:
# These authors contributed equally to this paper as first author

Structural and Congenital Heart Disease https://doi.org/10.32604/schd.2026.077612

Received 13 December 2025; Accepted 06 March 2026; Published online 25 March 2026

Abstract

Background: This study evaluated the impact of a comprehensive prevention program, which integrated eight evidence-based measures consistent with current clinical guidelines and practice standards, on ventilator-associated pneumonia (VAP) rates in a pediatric cardiac surgical intensive care unit (ICU). Methods: A quasi-experimental study was conducted from 2023 to 2024. We compared VAP rates across a 5-month pre-intervention period, a 12-month intervention period, and a 7-month post-intervention period in patients receiving mechanical ventilation for over 48 h. Additional outcomes, including postoperative length of stay were also assessed before and after the intervention. Results: Among 829 at-risk patients and 5677 ventilator-days, the VAP rates per 1000 ventilator-days were 25.7, 11.3, and 10.8 in the pre-intervention, intervention, and post-intervention periods, respectively. Poisson regression identified the intervention and post-intervention periods as protective factors for VAP. After adjusting for age, weight, emergency surgery, and cardiopulmonary bypass duration, VAP rates decreased by 56% during the intervention period (adjusted incidence rate ratio (IRR) 0.382, 95% CI 0.212–0.691; p = 0.001) and by 58% in the post-intervention period (adjusted IRR 0.452, 95% CI 0.232–0.882; p = 0.020). Postoperative length of stay also declined significantly from 22 (16, 35) days pre-intervention to 21 (15, 28) days post-intervention (p = 0.040). Conclusions: Implementation of the multidisciplinary prevention program was associated with a sustained reduction in VAP rates in a surgical pediatric cardiac ICU and may contribute to shorter postoperative hospital stays.

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Keywords

Ventilator-associated pneumonia; prevention program; surgical pediatric cardiac ICU; postoperative length of stay

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