Κατεύθυνση Επείγουσα Νοσηλευτική
Library of the School of Health Sciences

2024-04-19

2024

Plaviak Maria-Eirini

Καλογιάννη Αντωνία, Αναπληρώτρια Καθηγήτρια, Τμήματος Νοσηλευτικής, ΠΑΔΑ
Τουλιά Γεωργία, Αναπληρώτρια Καθηγήτρια, Τμήματος Νοσηλευτικής, ΠΑΔΑ
Αργυρίου Μιχάλης, Ιατρός, MSc, PhD

Στοματική υγιεινή και πρόληψη της σχετιζόμενης με τον αναπνευστήρα πνευμονία

Greek

Oral hygiene and prevention of ventilator - associated pneumonia

Introduction: 5-40% of hospitalized patients under mechanical ventilation (MV) in ICU develop ventilator related pneumonia (VAP). Oral hygiene is an essential strategy to reduce the accumulation of bacteria in the oropharynx that can cause VAP.
Aim: To investigate the effect of oral hygiene on the incidence of VAP.
Method: An international literature review was performed in the PubMed using the keywords: "intensive care unit", "ventilator-associated pneumonia", "oral hygiene", "chlorhexidine" and "tooth brushing". Study selection criteria were: (1) studies were randomized clinical trials written in the English language, (2) adult patients hospitalized in the ICU and under MV for ≥ 48 hours, (3) patients in the control group received usual care, whether they received oral hygiene care with another antiseptic agent or a medicinal agent, (4) the outcome of the studies was the incidence of VAP, (5) the studies were published from 2013 to 2023.
Results: Of the total of 119 studies identified during the online search, only 6 were included in the review. Two studies involved tooth brushing combined with rinsing with chlorhexidine solution, while the remaining studies only involved oral hygiene practices with rinsing solutions. More specifically, it was found that tooth brushing combined with rinsing with chlorhexidine solution appears to reduce the incidence of VAP compared to oral hygiene with chlorhexidine alone. Regarding the results of the studies looking at oral hygiene practices with solutions alone, it appeared that the incidence of VAP was similar between patients receiving chlorhexidine oral hygiene and those receiving probiotic bacterium Lactobacillus plantarum 299 (Lp299). On the other hand, the use of clove solution alone is associated with a lower incidence of VAP than chlorhexidine. Finally, the higher concentration of chlorhexidine is more effective in reducing the incidence of VAP.
Conclusion: Therefore, it appears that mouthwashes with a high concentration of chlorhexidine and oral hygiene with tooth brushing in combination with chlorhexidine are associated with a reduced incidence of VAP in mechanically ventilated patients in the ICU.

Health Sciences

Tooth brushing, Ventilator-associated pneumonia, Intensive Care Unit, Oral hygiene, Chlorhexidine

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https://pergamos.lib.uoa.gr/uoa/dl/object/3395507