Oral decontamination techniques and ventilator-associated pneumonia

Br J Nurs. 2017 Jun 8;26(11):594-599. doi: 10.12968/bjon.2017.26.11.594.

Abstract

Ventilator-associated pneumonia (VAP) is one of the major nosocomial infections in the intensive care unit (ICU), contributing to increased mortality and morbidity. Studies have shown that oral decontamination through the use of mechanical and pharmacological agents significantly reduces the incidence of VAP, but oral care practices in ICUs are not consistent. A double-blind randomised controlled trial was undertaken in the medical ICU of a tertiary care centre in India, to assess the efficacy of a toothbrush-based oral care technique in reducing incidence of VAP. Tooth-brushing with concurrent suctioning technique was not proved to be superior to mouth-swabbing. The greatest risk factor for developing VAP was the number of ventilator days (length of time on a ventilator). There was a statistical association between gender and presence of antibiotics with VAP.

Keywords: Bacterial colonisation; Healthcare-associated infections; Infection control; Oral hygiene; Ventilator-associated pneumonia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents, Local / therapeutic use*
  • Chlorhexidine / therapeutic use*
  • Cross Infection / drug therapy*
  • Cross Infection / prevention & control*
  • Decontamination / methods
  • Double-Blind Method
  • Female
  • Humans
  • Incidence
  • India / epidemiology
  • Intensive Care Units
  • Male
  • Middle Aged
  • Oral Hygiene / methods
  • Pneumonia, Ventilator-Associated / drug therapy*
  • Pneumonia, Ventilator-Associated / epidemiology
  • Pneumonia, Ventilator-Associated / prevention & control*
  • Respiration, Artificial / adverse effects*

Substances

  • Anti-Infective Agents, Local
  • Chlorhexidine