{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:52:06Z","timestamp":1788173526884,"version":"build-2803163510"},"reference-count":35,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":731,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jtcvsonline.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Thoracic and Cardiovascular Surgery"],"published-print":{"date-parts":[[2018,8]]},"DOI":"10.1016\/j.jtcvs.2018.02.091","type":"journal-article","created":{"date-parts":[[2018,3,12]],"date-time":"2018-03-12T17:35:08Z","timestamp":1520876108000},"page":"685-693","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of selective digestive decontamination without systemic antibiotics in a major heart surgery intensive care unit"],"prefix":"10.1016","volume":"156","author":[{"given":"Mar\u00eda Jes\u00fas","family":"P\u00e9rez-Granda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Barrio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Hortal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"Burillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mu\u00f1oz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Bouza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jtcvs.2018.02.091_bib1","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1378\/chest.122.6.2115","article-title":"Epidemiology and outcomes of ventilator-associated pneumonia in a large US database","volume":"122","author":"Rello","year":"2002","journal-title":"Chest"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib2","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.jhin.2006.06.019","article-title":"Postoperative infections after major heart surgery and prevention of ventilator-associated pneumonia: a one-day European prevalence study (ESGNI-008)","volume":"64","author":"Bouza","year":"2006","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib3","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jcrc.2007.11.013","article-title":"Ventilator-associated pneumonia: improving outcomes through guideline implementation","volume":"23","author":"Sinuff","year":"2008","journal-title":"J Crit Care"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jacc.2014.09.079","article-title":"Costs associated with health care-associated infections in cardiac surgery","volume":"65","author":"Greco","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib5","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jiph.2014.07.005","article-title":"Incidence and attributable costs of ventilator-associated pneumonia (VAP) in a tertiary-level intensive care unit (ICU) in northern India","volume":"8","author":"Mathai","year":"2015","journal-title":"J Infect Public Health"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib6","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/s12913-015-0917-x","article-title":"Healthcare utilization and costs associated with S. aureus and P. aeruginosa pneumonia in the intensive care unit: a retrospective observational cohort study in a US claims database","volume":"15","author":"Kyaw","year":"2015","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib7","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1055\/s-2002-35713","article-title":"The pathogenesis of ventilator-associated pneumonia","volume":"23","author":"Rumbak","year":"2002","journal-title":"Semina Respir Crit Care Med"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib8","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/1471-2334-14-119","article-title":"How to avoid microaspiration? A key element for the prevention of ventilator-associated pneumonia in intubated ICU patients","volume":"14","author":"Blot","year":"2014","journal-title":"BMC Infect Dis"},{"issue":"Suppl 3","key":"10.1016\/j.jtcvs.2018.02.091_bib9","first-page":"10","article-title":"[Pathogenesis and environmental factors in ventilator-associated pneumonia]","volume":"23","author":"Benitez","year":"2005","journal-title":"Enfermedades Infec Microbiolog Clin"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib10","doi-asserted-by":"crossref","first-page":"3617","DOI":"10.2147\/DDDT.S84587","article-title":"Selective oropharyngeal decontamination versus selective digestive decontamination in critically ill patients: a meta-analysis of randomized controlled trials","volume":"9","author":"Zhao","year":"2015","journal-title":"Drug Design Dev Ther"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib11","first-page":"650","article-title":"Ventilator-associated pneumonia rates after introducing selective digestive tract decontamination","volume":"47","author":"Schnabel","year":"2015","journal-title":"Infect Dis (London, England)"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib12","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.iccn.2013.08.005","article-title":"Reducing ventilator associated pneumonia in adult patients through high standards of oral care: a historical control study","volume":"30","author":"Cutler","year":"2014","journal-title":"Intens Crit Care Nurs"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib13","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1093\/cid\/ciu740","article-title":"Pneumonia prevention to decrease mortality in intensive care unit: a systematic review and meta-analysis","volume":"60","author":"Roquilly","year":"2015","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib14","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1093\/cid\/civ125","article-title":"Is selective decontamination of the digestive tract safe?","volume":"60","author":"Hurley","year":"2015","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib15","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/S1473-3099(12)70322-5","article-title":"Effect of selective decontamination on antimicrobial resistance in intensive care units: a systematic review and meta-analysis","volume":"13","author":"Daneman","year":"2013","journal-title":"Lancet Infect Dis"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib16","first-page":"734","article-title":"Use of selective digestive tract decontamination in European intensive cares: the ifs and whys","volume":"81","author":"Reis Miranda","year":"2015","journal-title":"Minerva Anestesiologica"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib17","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1186\/s13054-015-0967-9","article-title":"Selective decontamination and antibiotic resistance in ICUs","volume":"19","author":"Plantinga","year":"2015","journal-title":"Crit Care (London, England)"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib18","doi-asserted-by":"crossref","first-page":"R80","DOI":"10.1186\/cc7896","article-title":"Ventilator-associated pneumonia in patients undergoing major heart surgery: an incidence study in Europe","volume":"13","author":"Hortal","year":"2009","journal-title":"Critical Care (London, England)"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib19","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1007\/s00134-009-1523-3","article-title":"Incidence and risk factors for ventilator-associated pneumonia after major heart surgery","volume":"35","author":"Hortal","year":"2009","journal-title":"Intens Care Med"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib20","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.1097\/01.ccm.0000084807.15352.93","article-title":"Ventilator-associated pneumonia after heart surgery: a prospective analysis and the value of surveillance","volume":"31","author":"Bouza","year":"2003","journal-title":"Critical Care Med"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib21","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/0196-6553(88)90053-3","article-title":"CDC definitions for nosocomial infections, 1988","volume":"16","author":"Garner","year":"1988","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib22","first-page":"1672","article-title":"[The diagnosis of pneumonia in the ventilated patient]","volume":"120","author":"Pugin","year":"1990","journal-title":"Schweiz Medizin Wochenschr"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib23","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1183\/09031936.02.00012902","article-title":"Nosocomial tracheobronchitis in mechanically ventilated patients: incidence, aetiology and outcome","volume":"20","author":"Nseir","year":"2002","journal-title":"Eur Respir J"},{"issue":"Suppl 1","key":"10.1016\/j.jtcvs.2018.02.091_bib24","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1086\/653035","article-title":"Hospital-acquired pneumonia, health care-associated pneumonia, ventilator-associated pneumonia, and ventilator-associated tracheobronchitis: definitions and challenges in trial design","volume":"51","author":"Niederman","year":"2010","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.hrtlng.2013.09.002","article-title":"Implementing selective digestive tract decontamination in the intensive care unit: a qualitative analysis of nurse-identified considerations","volume":"43","author":"Marshall","year":"2014","journal-title":"Heart Lung"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib26","first-page":"161","article-title":"Selective decontamination of the digestive tract and oropharynx: after 30 years of debate is the definitive answer in sight?","volume":"22","author":"Price","year":"2016","journal-title":"Curr Opin Crit Care"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib27","first-page":"658","article-title":"Selective digestive decontamination. Why are intensivists more \u201cresistant\u201d than microorganisms?","volume":"77","author":"Silvestri","year":"2011","journal-title":"Minerva Anestesiologica"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib28","first-page":"g2197","article-title":"Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis","volume":"348","author":"Price","year":"2014","journal-title":"BMJ Clin Res Ed"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib29","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/S1473-3099(11)70035-4","article-title":"Selective digestive tract decontamination and selective oropharyngeal decontamination and antibiotic resistance in patients in intensive-care units: an open-label, clustered group-randomised, crossover study","volume":"11","author":"de Smet","year":"2011","journal-title":"Lancet Infect Dis"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib30","doi-asserted-by":"crossref","first-page":"2582","DOI":"10.1097\/CCM.0000000000001298","article-title":"Antibiotic-induced within-host resistance development of gram-negative bacteria in patients receiving selective decontamination or standard care","volume":"43","author":"Noteboom","year":"2015","journal-title":"Crit Care Med"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib31","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1128\/JCM.02234-12","article-title":"Emergence of OXA-48 and OXA-181 carbapenemases among Enterobacteriaceae in South Africa and evidence of in\u00a0vivo selection of colistin resistance as a consequence of selective decontamination of the gastrointestinal tract","volume":"51","author":"Brink","year":"2013","journal-title":"J Clin Microbiol"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib32","doi-asserted-by":"crossref","first-page":"3224","DOI":"10.1128\/AAC.02634-12","article-title":"Emergence of colistin resistance in Enterobacteriaceae after the introduction of selective digestive tract decontamination in an intensive care unit","volume":"7","author":"Halaby","year":"2013","journal-title":"Antimicrob Agents Chemother"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib33","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.ijantimicag.2013.08.008","article-title":"Rapid emergence of secondary resistance to gentamicin and colistin following selective digestive decontamination in patients with KPC-2-producing Klebsiella pneumoniae: a single-centre experience","volume":"42","author":"Lubbert","year":"2013","journal-title":"Int J Antimicrob Agents"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib34","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1007\/s00134-013-2997-6","article-title":"Pre-emptive broad-spectrum treatment for ventilator-associated pneumonia in high-risk patients","volume":"39","author":"Bouza","year":"2013","journal-title":"Intens Care Med"},{"key":"10.1016\/j.jtcvs.2018.02.091_bib35","doi-asserted-by":"crossref","first-page":"3842","DOI":"10.1186\/s12879-014-0714-x","article-title":"Topical antibiotics as a major contextual hazard toward bacteremia within selective digestive decontamination studies: a meta-analysis","volume":"14","author":"Hurley","year":"2014","journal-title":"BMC infect Dis"}],"container-title":["The Journal of Thoracic and Cardiovascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022522318307256?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022522318307256?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T16:55:19Z","timestamp":1758387319000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022522318307256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["S0022522318307256"],"URL":"https:\/\/doi.org\/10.1016\/j.jtcvs.2018.02.091","relation":{},"ISSN":["0022-5223"],"issn-type":[{"value":"0022-5223","type":"print"}],"subject":[],"published":{"date-parts":[[2018,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Impact of selective digestive decontamination without systemic antibiotics in a major heart surgery intensive care unit","name":"articletitle","label":"Article Title"},{"value":"The Journal of Thoracic and Cardiovascular Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jtcvs.2018.02.091","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery","name":"copyright","label":"Copyright"}]}}