The place of analysis of organ dysfunction in relation to the diagnosis of nosocomial pneumonia in intensive care is not yet defined.

New onset of pulmonary infiltrates, fever, and an increase in white blood cell (WBC) count accompanied by purulent tracheal secretions are clinically indicative of hospital-associated pneumonia (HAP). The low specificity and sensibility of diagnostic tests for HAP, however, tends to result in an extremely high incidence of missed diagnoses and may lay to high mortality.

The place of analysis of organ dysfunction in relation to the diagnosis of nosocomial pneumonia in intensive care is not yet defined, because early organ dysfunction may be the first symptoms noted by clinicians.

Inclusion Criteria:

Patients after cardiac/thoracic surgery with suspicion of HAP defined by the presence of the following criteria:

• new onset of pulmonary infiltrates,
• fever >38,3°C,
• increase in white blood cell (WBC) count
• purulent tracheal secretions
• but also:
• increased use of catecholamine,
• need of volemic expansion,
• depletion inability,
• confusion,
• hepatic perturbation with increased gamma-glutamyl transpeptidase (GGT)>2N or alkaline phosphatase (ALP) >1.5 N, or bilirubin >1.5N, or aminotransferase (AST or ALT>2 N).

Exclusion Criteria:

• child,
• pregnancy,
• end of life.

Patients in Intensive care unit after cardiac and/or thoracic surgery with a clinical suspicion of HAP