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- Title
Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator-associated pneumonia: a randomized study.
- Authors
de Lacerda Vidal, Claudia Fernanda; de Lacerda Vidal, Aurora Karla; de Moura Monteiro Jr., José Gildo; Cavalcanti, Aracele; Trindade Henriques, Ana Paula; Oliveira, Márcia; Godoy, Michele; Coutinho, Mirella; Sobral, Pollyanna Dutra; Claudia, Claudia Angela; Vilela7, Ângela; Gomes, Bárbara; Amorim Leandro, Marta; Montarroyos, Ulisses; de Alencar Ximenes, Ricardo; Ramos Lacerda11, Heloísa; Vidal, Aurora Karla de Lacerda; Monteiro, José Gildo de Moura Jr; Henriques, Ana Paula Trindade; Vilela, Claudia Ângela
- Abstract
<bold>Background: </bold>Nosocomial pneumonia has correlated to dental plaque and to oropharynx colonization in patients receiving mechanical ventilation. The interruption of this process, by preventing colonization of pathogenic bacteria, represents a potential procedure for the prevention of ventilator-associated pneumonia (VAP).<bold>Methods: </bold>The study design was a prospective, randomized trial to verify if oral hygiene through toothbrushing plus chlorhexidine in gel at 0.12% reduces the incidence of ventilatior-associated pneumonia, the duration of mechanical ventilation, the length of hospital stay and the mortality rate in ICUs, when compared to oral hygiene only with chlorhexidine, solution of 0.12%, without toothbrushing, in adult individuals under mechanical ventilation, hospitalized in Clinical/Surgical and Cardiology Intensive Care Units (ICU). The study protocol was approved by the Ethical Committee of Research of the Health Sciences Center of the Federal University of Pernambuco - Certificate of Ethical Committee Approval (CAAE) 04300012500005208. Because it was a randomized trial, the research used CONSORT 2010 checklist criteria.<bold>Results: </bold>Seven hundred sixteen patients were admitted into the ICU; 219 fulfilled the criteria for inclusion and 213 patients were included; 108 were randomized to control group and 105 to intervention group. Toothbrushing plus 0.12% chlorhexidine gel demonstrated a lower incidence of VAP throughout the follow up period, although the difference was not statistically significant (p = 0.084). There was a significant reduction of the mean time of mechanical ventilation in the toothbrushing group (p = 0.018). Regarding the length of hospital stay in the ICU and mortality rates, the difference was not statistically significant (p = 0.064).<bold>Conclusions: </bold>The results obtained showed that, among patients undergoing toothbrushing there was a significant reduction in duration of mechanical ventilation, and a tendency to reduce the incidence of VAP and length of ICU stay, although without statistical significance.<bold>Trial Registration: </bold>Retrospectively registered in the Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clínicos) - RBR-4TWH4M (4 September 2016).
- Subjects
BRAZIL; ORAL hygiene; TOOTHBRUSHES; CHLORHEXIDINE; PNEUMONIA; MECHANICAL ventilators; PREVENTION of communicable diseases; COMPARATIVE studies; INTENSIVE care units; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MOUTHWASHES; RESEARCH; TOOTH care &; hygiene; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness; VENTILATOR-associated pneumonia; PREVENTION
- Publication
BMC Infectious Diseases, 2017, Vol 17, p1
- ISSN
1471-2334
- Publication type
journal article
- DOI
10.1186/s12879-017-2188-0