Evaluating the Effect of Chlorhexidine and Tooth Brushing in Preventing the Ventilator Associated Pneumonia

Background and Objective: Ventilator-associated pneumonia is a common infection in intensive care units leading to increased morbidity and mortality. This study was conducted to examine the effects of mechanical (tooth brushing), pharmacological (topical oral chlorhexidine), and their combination (tooth brushing plus chlorhexidine) in oral care on preventing the ventilator-associated pneumonia of critically ill patients in intensive care units. Materials and Methods: Patients admitted to intensive care units of Ayatollah Mousavi Hospital of Zanjan that received intubation within ۲۴ hours were considered as subjects of this study.  The patients (n= ۱۸۰) were randomly allocated to three groups: first group (n=۶۰) was administered ۰.۱۲% solution of chlorhexidine oral swab; second group (n=۶۱) used tooth brushing; third group (n=۵۹) used both tooth brushing and chlorhexidine oral swab. Ventilator-associated pneumonia was determined by using the Clinical Pulmonary Infection Score. Results: The three groups did not differ significantly in clinical characteristics. At days ۳ and ۷, pneumonia developed in ۲۹.۴% and ۵۹.۴% of patients, respectively. The frequency of pneumonia at days ۳ and ۷ was not different in three groups. Conclusion: Mechanical and pharmacological or their combination in oral care did not point to any kind of superiority of one approach over another in terms of the prevention of ventilator-associated pneumonia.

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Keywords: Chlorhexidine ، Toothbrushing ، Ventilator-Associated Pneumonia ، Clinical Pulmonary Infection Score