Critical Care, Mechanical Ventilation, Oral Care, Toothbrushing, Ventilator Associated Pneumonia Prevention
Conditions
Keywords
Critical care, Mechanical ventilation, Ventilator associated pneumonia, Oral care
Brief summary
Effect of toothbrushing in oral care of mechanically ventilated critically ill patients on prevention of ventilator associated pneumonia
Detailed description
Prospective, before and after study in 5 Intensive Care Units (ICUs) of a university hospital. The before period (control phase, 6 months): standard oral care 3 times a day in every consecutive intubated patients in the participating ICUs The interphase period (1 month): formal training of all the nurses, physicians and residents on the use of toothbrushing during oral care The after period: (study phase, 6 months): standard oral care with tooth brushing 3 times a day in every consecutive intubated patients in the participating ICUs
Interventions
OTHERToothbrushing
Toothbrushing associated with standard oral care in mechanically ventilated patients
Sponsors
University Hospital, Clermont-Ferrand
Study design
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients * Intubated mechanically ventilated ICU patient * Platelets count \>50G/L
Exclusion criteria
* Edentulous patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nosocomial ventilator associated pneumonia | at Day-28 | Presence of at least two signs (body fever greater than 38°C; leukocytosis greater than 12000/ml or leukopenia below 4000/ml, purulent pulmonary secretions) associated with the appearance of a new infiltrate or modification of an existing infiltrate on chest-X-ray. Confirmation by a lower respiratory tract sample using a quantitative culture with a predefined positive threshold. Hospital-acquired pneumonia was defined as a pneumonia that occurs at least 48 hours after admission, which was not incubating at time of admission (Am J Respir Crit Care Med 2005; 171, 388-416). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tracheobronchitis | at Day-28 | Association of at least two signs (fever above 38.0°C, Leucocytosis above 12000/ml or purulent pulmonary secretions) with isolation of bacteria in a lower respiratory tract sample without modification of chest-X-Ray. |
| ICU length of stay | at Day-90 | — |
| ICU mortality | at Day-90 | — |
| Hospital mortality | at Day-90 | — |
| Antibiotic free days | at Day-90 | — |
Countries
France
Outcome results
None listed