Comparison of the effect of oral care with four different antiseptics to prevent ventilator-associated pneumonia in adults: protocol for a network meta-analysis

Abstract

BackgroundVentilator-associated pneumonia (VAP) is defined as the occurrence of pneumonia in patients receiving mechanical ventilation for more than 48 h after endotracheal intubation. The implementation of effective oral care with antiseptics may reduce the incidence of ventilator-associated pneumonia. However, previous studies have been unclear about the best antiseptic for this purpose. Therefore, present protocol proposed to perform a network meta-analysis to evaluate the efficacy of different antiseptics to prevent ventilator-associated pneumonia.Methods/designWe will search CNKI, WanFang database, PubMed, Web of Science, Cochrane Library, EMBASE, SinoMed from their inception to March 2016. There are no restrictions on language, publication year, or publication type. Only randomized clinical trials (RCTs) with antiseptics to prevent ventilator-associated pneumonia will be considered. Study selection and data collection will be independently performed by two reviewers. Risk of bias assessments will be completed using the Cochrane risk of bias scale. The primary outcome is VAP morbidity. A network meta-analysis will be conducted to compare the effect of four different antiseptics on patient-relevant efficacy. Subgroup analyses will be performed by the type of setting and length of mechanical ventilation, and sensitivity analyses will be conducted to assess the robustness of the findings.DiscussionOral care to prevent ventilator-associated pneumonia has been widely used. The efficacy of usual oral antiseptics have been assessed mainly using traditional meta-analysis. However, it was unclear which oral care solution is best used for oral care and there were no head-to-head RCT to compare the efficacy of four antiseptics. The proposed network meta-analysis will compare four antiseptics and rank the results using network meta-analysis to decide which was the best.Systematic review registrationPROSPERO CRD42016038088 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0496-5) contains supplementary material, which is available to authorized users.

Nursing in Intensive Care Unit: Exploring Factors Related to Ventilator-Associated Pneumonia

“…Furthermore, oral care with preservatives can reduce the incidence of ventilator-associated pneumonia [22,[29][30][31] . However, there are many kinds of oral care solutions at present.…”

Perfil Odontológico De Pacientes Internados Na Unidade De Terapia Intensiva De Um Hospital Oncológico Do Sudoeste Do Paraná

“…Sabe-se que a higienização oral, bem como, a utilização de solução antimicrobiana como coadjuvante ou método principal para higiene oral de idosos ou indivíduos com limitação física objetivando, com isto, prevenir doenças sistêmicas como pneumonia bacteriana e endocardites são de extrema importância. Entende-se como solução antimicrobiana oral, uma substância contendo derivados fenólicos como o timol, gluconato de clorexidina, esta substância apresenta boa substantividade, pois se adere às superfícies orais, mostrando efeitos bacteriostáticos até 12 horas após sua utilização (KAHN et al, 2008;ZHANG et al, 2017).…”

“…Outra medida útil para uma significativa descontaminação da cavidade oral e concomitante redução da incidência de infecção nosocomial em pacientes internados em UTI foi a utilização de digluconato de clorexidina a 0,12%, que permite a retenção de mais de 30% da clorexidina, por bochecho, nos tecidos moles, estendendo o período de atividade antimicrobiana (PEDREIRA et al, 2009;BARBOSA et al, 2010;ZHANG et al, 2017).…”

Infectious Complications after Spinal Cord Injury

“…After intubation and mechanical ventilation, ventilator-associated pneumonia (VAP) may develop. VAP is in fact the occurrence of pneumonia in patients with mechanical ventilation, occurring more than 48 h after endotracheal intubation [49]. VAP is the most frequent nosocomial infection in patients with mechanical ventilation and is associated with longer intensive care unit stay, longer duration of mechanical ventilation, and high morbidity and mortality [4].…”

“…Using effective oral care with antiseptics is associated with the reduction of the incidence of ventilator-associated pneumonia. Oral care solutions have been widely used to prevent ventilator-associated pneumonia [49]. Routine cleaning and disinfection of ventilators can play an important role in VAP prevention and management approach [53].…”