Uso de clorexidina 2% gel e escovação mecânica na higiene bucal de pacientes sob ventilação mecânica: efeitos na pneumonia associada a ventilador

Abstract

ObjectiveTo evaluate the effects of oral chlorhexidine hygiene with toothbrushing on the rate of ventilator-associated pneumonia in a mixed population of critically ill patients under prolonged mechanical ventilation. MethodsProspective, randomized, and placebo-controlled pilot study. Patients who were receiving mechanical ventilation, had been admitted less than 24 hours prior, and were anticipated to require mechanical ventilation for more than 72 hours were included in the study. The patients were randomly divided into one of the following groups: chlorhexidine hygiene with toothbrushing or a placebo group (gel with the same color and consistency and toothbrushing). ResultsThe planned interim analysis was conducted using 52 patients, and the study was terminated prematurely. In total, 28 patients were included in the chlorhexidine / toothbrushing group, and 24 patients were included in the placebo group. Ventilator-associated pneumonia occurred in 45.8% of the placebo group and in 64.3% of the chlorhexidine hygiene with toothbrushing group (RR=1.4; 95% CI=0.83-2.34; p=0.29). ConclusionBecause the study was terminated due to futility, it was not possible to evaluate the impact of oral hygiene using 2% chlorhexidine and toothbrushing on the incidence of ventilator-associated pneumonia in this heterogeneous population of critical patients receiving long-term mechanical ventilation, and no beneficial effect was observed for this intervention.

Conhecimento da equipe de enfermagem sobre a importância da higiene oral na prevenção da PAVM

“…No caso de pacientes internados em Unidade de Terapia Intensiva (UTI) existe uma alta incidência de infecções orais, o que gera uma preocupação ainda maior com relação a periculosidade da contaminação. Uma das questões mais citadas com relação a presença de bactérias gram-negativas nesta área se dá através da higiene oral (HO) deficiente (MEINBERG et al, 2012;VILELA et al, 2015).…”

Topical Antimicrobials for Burn Infections – An Update

“…3E) is a common antiseptic agent that is used in many oral hygiene [236] and hand sanitization products [237]. The substance possesses broad-spectrum activity and causes low irritability.…”

Conhecimento da equipe de Enfermagem sobre a importância da Higiene Oral na Prevenção da PAVM

“…A pneumonia associada à ventilação mecânica (PAVM) é resultado do desequilíbrio entre os mecanismos de defesa do indivíduo e o agente microbiano. A PAVM geralmente se desenvolve após 48 horas de intubação orotraqueal (GIROU, 2003 (MEINBERG et al, 2012;VILELA et al, 2015).…”