Document Detail

Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma.
MedLine Citation:
PMID:  16540962     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effect of a regular oropharyngeal application of povidone-iodine on the prevalence of ventilator-associated pneumonia in patients with severe head trauma. DESIGN: Prospective randomized study. SETTING: A surgical intensive care unit of a university hospital. INTERVENTIONS: Patients with severe head trauma (Glasgow Coma Score of < or =8) expected to need ventilation for > or =2 days were prospectively randomized into three groups: those receiving nasopharynx and oropharynx rinsing with 20 mL of a 10% povidone-iodine aqueous solution, reconstituted in a 60-mL solution with sterile water (povidone-iodine group); those receiving nasopharynx and oropharynx rinsing with 60 mL of saline solution (saline group); or those undergoing a standard regimen without any instillation but with aspiration of oropharyngeal secretions (control group). MEASUREMENTS AND MAIN RESULTS: The prevalence of ventilator-associated pneumonia was compared among the three groups. A total of 98 patients were analyzed (povidone-iodine group, n = 36; saline group, n = 31; and control group, n = 31). A total of 28 cases of ventilator-associated pneumonia were diagnosed. There was a significant decrease in the rate of ventilator-associated pneumonia in the povidone-iodine group when compared with the saline and control groups (3 of 36 patients [8%] vs. 12 of 31 patients [39%] and 13 of 31 patients [42%], respectively; p = .003 and .001, respectively). The length of stay and mortality in the surgical intensive care unit were not statistically different between the three groups. CONCLUSIONS: The regular administration of povidone-iodine may be an effective strategy for decreasing the prevalence of ventilator-associated pneumonia in patients with severe head trauma.
Philippe Seguin; Michèle Tanguy; Bruno Laviolle; Olivier Tirel; Yannick Mallédant
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Critical care medicine     Volume:  34     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-24     Completed Date:  2006-05-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1514-9     Citation Subset:  AIM; IM    
Surgical Intensive Care Unit, INSERM U620, Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033 Rennes cedex, France.
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MeSH Terms
Analysis of Variance
Anti-Infective Agents, Local / therapeutic use*
Head Injuries, Closed / therapy*
Pneumonia / etiology,  prevention & control*
Povidone-Iodine / therapeutic use*
Prospective Studies
Respiration, Artificial / adverse effects*
Reg. No./Substance:
0/Anti-Infective Agents, Local; 25655-41-8/Povidone-Iodine
Comment In:
Crit Care Med. 2006 May;34(5):1572-3   [PMID:  16633268 ]

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