Document Detail

Ventilator-associated pneumonia with or without toothbrushing: a randomized controlled trial.
MedLine Citation:
PMID:  22422274     Owner:  NLM     Status:  MEDLINE    
Certain guidelines for the prevention of ventilator-associated pneumonia (VAP) recommend oral care with chlorhexidine, but none refer to the use of a toothbrush for oral hygiene. The role of toothbrush use has received scant attention. Thus, the objective of this study was to compare the incidence of VAP in critical care patients receiving oral care with and without manual brushing of the teeth. This was a randomized clinical trial developed in a 24-bed medical-surgical intensive care unit (ICU). Patients undergoing invasive mechanical ventilation for than 24 h were included. Patients were randomly assigned to receive oral care with or without toothbrushing. All patients received oral care with 0.12 % chlorhexidine digluconate. Tracheal aspirate samples were obtained during endotracheal intubation, then twice a week, and, finally, on extubation. There were no significant differences between the two groups of patients in the baseline characteristics. We found no statistically significant differences between the groups regarding the incidence of VAP (21 of 217 [9.7 %] with toothbrushing vs. 24 of 219 [11.0 %] without toothbrushing; odds ratio [OR] = 0.87, 95 % confidence interval [CI] = 0.469-1.615; p = 0.75). Adding manual toothbrushing to chlorhexidine oral care does not help to prevent VAP in critical care patients on mechanical ventilation.
L Lorente; M Lecuona; A Jiménez; S Palmero; E Pastor; N Lafuente; M J Ramos; M L Mora; A Sierra
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-03-16
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  31     ISSN:  1435-4373     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-25     Completed Date:  2013-02-04     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2621-9     Citation Subset:  IM    
Department of Critical Care, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320 Santa Cruz de Tenerife, Spain.
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MeSH Terms
Anti-Infective Agents, Local / administration & dosage*
Chlorhexidine / administration & dosage,  analogs & derivatives
Critical Care
Intensive Care Units
Intubation, Intratracheal
Middle Aged
Odds Ratio
Pneumonia, Ventilator-Associated / microbiology,  prevention & control*
Respiration, Artificial / adverse effects
Toothbrushing / methods*
Trachea / microbiology
Reg. No./Substance:
0/Anti-Infective Agents, Local; 55-56-1/Chlorhexidine; MOR84MUD8E/chlorhexidine gluconate
Comment In:
Eur J Clin Microbiol Infect Dis. 2012 Nov;31(11):3257-8   [PMID:  22898725 ]

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