Farid Zand1, Leili Zahed2, Parisa Mansouri3, Freshte Dehghanrad2, Maryam Bahrani1, Mohammad Ghorbani1. 1. Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 2. Fatemeh Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran. 3. Fatemeh Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: Mansoorip@sums.ac.ir.
Abstract
BACKGROUND: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of oropharyngeal colonization and VAP. MATERIALS AND METHODS: This study was performed on 114 patients from trauma, surgery, neurosurgery, and general ICUs randomly allocated to two groups underoral care with 0.2% and 2% chlorhexidine solution. A multidisciplinary team approved the oral care protocol. Data was collected using a demographic information form, APACHE IV form, Beck oral assessment scale, mucosal-plaque assessment scale, and oropharyngeal swab culture. RESULTS: The results showed a significant reduction in VAP (p=0.007) and oropharyngeal colonization (p=0.007) in the group under oral care with 2% chlorhexidine solution compared with the other group. However, no significant difference was found between the two groups in terms of oropharyngeal adverse effects (p=0.361). CONCLUSION: Oral decontamination with 2% compared to 0.2% chlorhexidine is a more effective method in the prevention of VAP and reduction of oropharyngeal colonization (especially gram-positive).
RCT Entities:
BACKGROUND: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of oropharyngeal colonization and VAP. MATERIALS AND METHODS: This study was performed on 114 patients from trauma, surgery, neurosurgery, and general ICUs randomly allocated to two groups under oral care with 0.2% and 2% chlorhexidine solution. A multidisciplinary team approved the oral care protocol. Data was collected using a demographic information form, APACHE IV form, Beck oral assessment scale, mucosal-plaque assessment scale, and oropharyngeal swab culture. RESULTS: The results showed a significant reduction in VAP (p=0.007) and oropharyngeal colonization (p=0.007) in the group under oral care with 2% chlorhexidine solution compared with the other group. However, no significant difference was found between the two groups in terms of oropharyngeal adverse effects (p=0.361). CONCLUSION: Oral decontamination with 2% compared to 0.2% chlorhexidine is a more effective method in the prevention of VAP and reduction of oropharyngeal colonization (especially gram-positive).
Authors: Barbara H Rosario; Humaira Shafi; Anthony C A Yii; Louis Y Tee; Arron S H Ang; Gek Kheng Png; Wendy S T Ang; Yan Qing Lee; Pei Ting Tan; Aniruddha Sahu; Lin Fang Zhou; Yi Ling Zheng; Roslinda Binte Slamat; Aza A M Taha Journal: Eur Geriatr Med Date: 2021-06-03 Impact factor: 1.710
Authors: Mieke Deschepper; Willem Waegeman; Kristof Eeckloo; Dirk Vogelaers; Stijn Blot Journal: Intensive Care Med Date: 2018-05-09 Impact factor: 17.440