[PDF] Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. | Semantic Scholar (2024)

The evidence regarding the efficacy of chlorhexidine gluconate oral care in reducing ventilator-associated events in specific intensive care unit populations is contradictory and may be beneficial only in the cardiac surgical population.

A model in which different health care professionals can cooperate to reduce the incidence of VAP and improve oral health conditions is suggested.

Although a reduction in the number of admissions or complexity of cases was not observed in the study period, multidisciplinary staff practices were essential for controllingHAIs and the presence of dental professionals can assist in the control of HAIs related to MV.

The study revealed that CHX has a more powerful effect than HEX and NS in improving the oral mucosa and decreasing colonization of both the oropharynx and trachea, and recommends the use of a CHX solution as oral mouth care in critically ill patients.

Among mechanically ventilated ICU patients, no benefit was observed for de-adoption of chlorhexidine and implementation of an oral care bundle on ICU mortality, IVACs, oral procedural pain, or time to extubation, but the intervention may improve oral health.

It is thought that the methods applied to eliminate the risk of ventilator-associated pneumonia and nursing practices will contribute to direct the care practices of the staff in charge and affect the patient care results positively.

Bradford Hill criteria analysis failed to support a causal relationship between periodontal microbes/oral health care and respiratory diseases such as pneumonia.

Although a causal relationship cannot be inferred from these data, the successive surveys revealed a potential impact of the VAP bundle campaign on both the respiratory care of ventilated patients and the prevalence of VAP in Belgian ICUs encouraging them to follow the guidelines.

Results indicate that topical PV-I application reduces the number of bacteria entering the lower respiratory tract and may help prevent VAP.

To evaluate the anti-inflammatory and anti-bacterial effects of mouthwashes for critical care patients, the PubMed, EMBASE, CENTRAL, and grey literature databases were searched by descriptors combining population and intervention (mouthwashes).

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High quality evidence from 18 RCTs shows that CHX mouthrinse or gel, as part of OHC, reduces the risk of VAP compared to placebo or usual care, which is equivalent to a number needed to treat for an additional beneficial outcome (NNTB) of 17, which indicates that for every 17 ventilated patients in intensive care receiving OHC including chlorhexidine, one outcome of V AP would be prevented.

There is moderate quality evidence that CHX mouthrinse or gel, as part of OHC, compared to placebo or usual care is associated with a reduction in VAP, but there was insufficient evidence to determine whether there is a difference between CHX and placebo/usual care in the outcomes of mortality.

The peer-reviewed literature was appraised to determine the best available evidence for providing oral care to intensive care patients receiving mechanical ventilation and to document a research agenda for this important activity in optimizing patients' outcomes.

This project specifically addressed timed oral care of mechanically ventilated patients on a 24‐bed stroke, neurologic, and medical ICU to support the premise that oral care, including timed toothbrushing, combined with the VAP bundle can mitigate and prevent the occurrence of VAP.

The findings suggest that the addition of electric toothbrushing to standard oral care with 0.12% chlorhexidine digluconate is not effective for the prevention of VAP.

Chlorhexidine, but not toothbrushing, reduced early ventilator-associated pneumonia in patients without pneumonia at baseline, and chlorhexidine significantly reduced the incidence of pneumonia on day 3 among patients who had CPIS <6 at baseline.

Findings suggest that, as an inexpensive alternative to existing protocols, toothbrushing twice daily with purified water reduces VAP and improves oral health and hygiene.

Mixed results were shown and the majority failed to demonstrate a significant reduction in the incidence of nosocomial pneumonia with the use of chlorhexidine, however, the cardiothoracic surgery ICU patient population may benefit from its use.

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