Respiratory failure (adult ICU patients requiring oxygen support and eligible for high-flow oxygen therapy [HFOT]). Respiratory failure, unspecified
Conditions
Interventions
Intervention 1: Intervention group: In addition to receiving standard oral care according to the routine ICU protocol, the intervention group will also receive high-flow oxygen therapy (HFOT). The int
Sponsors
Birjand University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Age 18 years and older Being hospitalized in the intensive care unit No change in systemic antibiotic regimen (start of new medication or dose change) in the past 48 hours Intubation and connection to a ventilator Having acute hypoxemic respiratory failure that requires oxygen Ability of the patient or their legal guardian to provide written informed consent
Exclusion criteria
Exclusion criteria: Tracheal (extubation) removal of the tube Patient death or transfer from the intensive care unit before the end of the study Initiation of new systemic antibiotics during the 24-hour study period Use of strong antibacterial mouthwashes (such as chlorhexidine 0.2%) in the 12 hours prior to initial sampling Presence of active bleeding or severe oral disease (such as oral tumors, acute periodontitis, or dental abscesses) that could confound microbiological results The occurrence of severe respiratory or hemodynamic complications that require an immediate change in oxygen therapy Withdrawal of the patient or their legal guardian from continued participation in the study at any stage
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total oral microbial load (CFU/mL) measured before and 24 hours after initiation of the intervention in each group. Timepoint: Before initiation of the intervention and 24 hours after initiation of the intervention. Method of measurement: Before the intervention, an initial oral sample will be collected using a sterile Dacron swab from three oral sites, including the inner mucosa of the right cheek, the dorsal surface of the tongue, and the hard palate. After sampling, the swab will be placed into a tube containing 1 mL of sterile normal saline, labeled, and stored at 4°C until transfer to the laboratory. A second sample will be collected 24 hours after initiation of the intervention using the same procedure and from the same oral sites. In the laboratory, the samples will be vortexed for 30 seconds to release microorganisms into the transport medium. Considering the high microbial load of the oral cavity, serial dilutions will be prepared up to appropriate dilutions (10^-4 or 10^-5 depending on sample turbidity). Subsequently, 10 µL of each dilution will be inoculated onto Blood Agar for total aerobic bacterial count and MacConkey Agar for identification and enumeration of facultative Gram-negative bacilli. The culture plates will be incubated at 37°C for 24–48 hours. Countable colonies (30–300 colonies) will be identified, and the results will be reported as colony-forming units per milliliter (CFU/mL). | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactDayani Maryam
Birjand University of Medical Sciences
Outcome results
None listed