Editor: Akhmetova Aigerim
Author: Aigerim Akhmetova
Ventilator-related pneumonia is pneumonia that develops no earlier than 48 hours after the start of the ventilator, with no signs of any other lung infection. Oral care using mouthwash, gel, toothbrush, or a combination of both, along with suction of secretions, can reduce the risk of pneumonia in these patients.
To assess the impact of oral care on the incidence of ventilator-associated pneumonia in critically ill patients receiving ventilators in intensive care units, the following databases were searched: Cochrane Central RCT, MEDLINE Ovid, Embase Ovid, LILACS BIREME, CINAHL EBSCO.
13 RCTs (1206 participants) out of 40 show that mouthwash or gel probably reduces the incidence of nosocomial pneumonia compared to placebo from 26% to about 18%(medium confidence). There was no evidence of a difference between the interventions in terms of mortality outcomes. The fact that brushing teeth (including antiseptics) can reduce the incidence of ventilator-associated pneumonia has evidence of a low degree of confidence.
It can be concluded that chlorhexidine mouthwash or gel probably reduces the incidence of ventilator-associated pneumonia (VAP) in critically ill patients, from 26% to about 18% compared to placebo or conventional care. Oral hygiene, which includes both antiseptics and brushing your teeth, may be more effective than brushing your mouth with a single antiseptic to reduce the frequency of VAP and the length of stay in the intensive care unit.
Source: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008367.pub4/...
