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Importance  Ventilator‐associated pneumonia ( VAP ) is one of the most common complications after cardiac surgery in children with congenital heart disease ( CHD ). Early prediction of the incidence of  VAP  is important for clinical prevention and treatment.    Objective  To determine the value of serum C‐reactive protein ( CRP ) levels and the Pediatric Risk of Mortality  III  ( PRISM III ) score in predicting the risk of postoperative  VAP  in pediatric patients with  CHD .    Methods  We performed a retrospective review of clinical data of 481 pediatric patients with  CHD  who were admitted to our pediatric intensive care unit. These patients received mechanical ventilation for 48 hours or longer after corrective surgery. On the basis of their clinical manifestations and laboratory results, patients were separated into two groups of those with  VAP  and those without  VAP .  CRP  levels were measured and  PRISM III  scores were collected within 12 hours of admission to the pediatric intensive care unit. The Pearson correlation coefficient was used to evaluate the association of  CRP  levels and the  PRISM  score with the occurrence of postoperative  VAP . A linear regression model was constructed to obtain a joint function and receiver operating curves were used to assess the predictive value.    Results   CRP  levels and the  PRISM III  score in the  VAP  group were significantly higher than those in the non‐ VAP  group ( P <  0.05). Receiver operating curves suggested that using  CRP  + the  PRISM III  score to predict the incidence of  VAP  after congenial heart surgery was more accurate than using either of them alone ( CRP  + the  PRISM III  score: sensitivity: 53.2%, specificity: 85.7%). When  CRP  + the  PRISM III  score was greater than 45.460, patients were more likely to have  VAP .    Interpretation  Although using  CRP  levels plus the  PRISM III  score to predict the incidence of  VAP  after congenial heart surgery is more accurate than using either of them alone, its predictive value is still limited.

pediatric investigation

Predictive value of C‐reactive protein and the Pediatric Risk of Mortality  III  Score for occurrence of postoperative ventilator‐associated pneumonia in pediatric patients with congenital heart disease