Ventilator-Associated Pneumonia
Conditions
Interventions
Intervention Group: 105 individuals submitted intubation and mechanical ventilation undergoing oral hygiene using toothbrushes with small and soft bristles, and dental gel based on 0.12% chlorhexidine
Procedure/surgery
E06.761.726.794
Sponsors
Universidade Federal de Pernambuco
Universidade de Pernambuco
Eligibility
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Individuals with age equal or greater than 18 years; submitted to endotracheal intubation; expected to remain on mechanical ventilation for >48 hours; without evidence of pulmonary infection at Intensive Care Unit admission.
Exclusion criteria
Exclusion criteria: Individuals without teeth; suspicion of pneumonia at the time of endotracheal intubation; pregnancy; tracheostomy; chlorhexidine allergy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Reduction of incidence of ventilator-associated pneumonia (VAP), expressed in percentage as episodes per patients under mechanical ventilation, and differences between the groups with "p" values ??with 95% confidence interval. ;Among the 213 patients, ventilatior-associated pneumonia occurred in 45 (21.1%), 28 (62,2%) being patients from the control group and 17 (37,8%) from the intervention group, with global incidence density equal to 14.2 by 1.000 MV/day. The use of toothbrushing plus 0.12% chlorhexidine gel demonstrated a lower incidence of VAP throughout the follow up period, although the difference was not statistically significant (p = 0.084). | — |
Secondary
| Measure | Time frame |
|---|---|
| Identify differences in mortality rate, duration of mechanical ventilation and length of hospital stay in Intensive Care Unit (ICU) between the studied groups, with "p" values ??with 95% confidence interval.;As to the mortality, among the 213 patients, death occurred in 47 (22,06%); 27 (57,5%) being patients from the control group and 20 (42,5%) from the intervention group. The relative risk of death (RR=1,41) was higher in the control group, increasing the risk of death by 41%, although it was not statistically significant (p=0,296). Regarding the length of hospital stay in the ICU, the difference was not statistically significant (p= 0.064). There was a significant reduction of the mean time of mechanical ventilation in the group of patients who were submitted to toothbrushing (p= 0.018). | — |
Countries
Brazil
Contacts
Public ContactClaudia Vidal
Universidade Federal de Pernambuco
Outcome results
None listed