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. 2016 Mar;25(2):173-7.
doi: 10.4037/ajcc2016823.

No Decrease in Early Ventilator-Associated Pneumonia After Early Use of Chlorhexidine

Terrence Wong  1 , Adam B Schlichting  2 , Andrew J Stoltze  1 , Brian M Fuller  1 , Amanda Peacock  1 , Kari K Harland  1 , Azeemuddin Ahmed  1 , Nicholas Mohr  1
Affiliations

No Decrease in Early Ventilator-Associated Pneumonia After Early Use of Chlorhexidine

Terrence Wong et al. Am J Crit Care. 2016 Mar.

Abstract

Background: Oral chlorhexidine prophylaxis can decrease occurrence of ventilator-associated pneumonia. However, the importance of timing has never been fully explored.

Objective: To see if early administration of oral chlorhexidine is associated with lower incidence of early ventilator-associated pneumonia (within 5 days of admission to intensive care unit) in intubated air ambulance patients.

Methods: A single-center, retrospective cohort study of intubated adults transported by a university-based air ambulance service and admitted to a surgical intensive care unit from July 2011 through April 2013. Primary exposure was time from helicopter retrieval to the first dose of oral chlorhexidine in the intensive care unit. Early chlorhexidine was defined as receipt of the drug within 6 hours of helicopter departure. The primary outcome was clinical diagnosis of early ventilator-associated pneumonia. Patients who were less than 18 years old, died within 72 hours of admission, or had pneumonia at admission were excluded.

Results: Among 134 patients, 49% were treated with chlorhexidine before 6 hours, 84% were treated before 12 hours, and 11% were treated for early pneumonia. Early chlorhexidine (before 6 hours; 15%) was not associated (P = .21) with early pneumonia (8%). Furthermore, median times to chlorhexidine did not differ significantly (P = .23) between patients in whom pneumonia developed (5.2 hours) and patients with no pneumonia (6.1 hours).

Conclusions: Early administration of oral chlorhexidine in intubated patients was not associated with a reduction in the incidence of ventilator-associated pneumonia in a surgical intensive care unit with high rates of chlorhexidine administration before 12 hours.

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Figures

Figure 1
Figure 1
Proportion of patients treated with chlorhexidine by time, stratified by early pneumonia status.
See this image and copyright information in PMC

References

    1. Eom JS, Lee MS, Chun HK, et al. The impact of a ventilator bundle on preventing ventilator-associated pneumonia: a multicenter study. American journal of infection control. 2014;42(1):34–37. - PubMed
    1. To KB, Napolitano LM. Common complications in the critically ill patient. The Surgical clinics of North America. 2012;92(6):1519–1557. - PubMed
    1. Cutler LR, Sluman P. Reducing ventilator associated pneumonia in adult patients through high standards of oral care: a historical control study. Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses. 2014;30(2):61–68. - PubMed
    1. Chan EY. Oral decontamination with chlorhexidine reduced ventilator associated pneumonia in patients needing mechanical ventilation for >/=48 hours. Evidence-based nursing. 2007;10(1):19. - PubMed
    1. Kollef MH. Ventilator-associated pneumonia. A multivariate analysis. JAMA : the journal of the American Medical Association. 1993;270(16):1965–1970. - PubMed

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