The effect of different oral hygiene treatments on the occurrence of ventilator associated pneumonia (VAP) in ventilated patients

Abstract

Background: We compared the incidence of ventilator associated pneumonia (VAP) among patients treated with comprehensive oral care to those treated with conventional methods of oral care.

Methods: We conducted a prospective, controlled study in an intensive care unit of 90 ventilated patients. Patients in the study group received a comprehensive oral hygiene treatment regimen that involved tooth brushing, suctioning, sodium bicarbonate, rinsing with an antiseptic solution containing 1.5% hydrogen peroxide and a mouth moisturiser. Patients in the control group received a more conventional treatment that included cleaning with a sponge and atraumatic clamp, and rinsing with a 0.2% solution of chlorhexidine gluconate.

Results: Among the 90 patients admitted to the ICU, 8.9% of the study group developed VAP compared with 33.3% of the control group (p< 0.004). The development of VAP per 1,000 ventilation days was 10.2 in the study group, and 29.5 in the control group (p< 0.06). The mean number of ventilation days and the mean number of hospitalisation days were also lower in the study group.

Conclusions: In patients who are ventilated, a comprehensive oral hygiene treatment regimen that includes tooth brushing, suctioning and rinsing with an antiseptic is more effective in preventing VAP than more conventional protocols.

Keywords: Chlorhexidine gluconate; VAP; comprehensive oral hygiene; nosocomial infection; tooth brushing; ventilator associated pneumonia.