Impact of oral hygiene in patients undergoing mechanical ventilation in the COVID-19 pandemic

Abstract

SUMMARY COVID-19, caused by SARS-CoV-2, can present respiratory complications that often lead patients to depend on mechanical ventilation (MV) for several days. It is known that Pneumonia Associated with Mechanical Ventilation (PAMV) is frequent in patients who use this equipment for a long time. As a consequence of COVID-19, its prolonged use can lead to a worse prognosis for the patients. For this reason, in addition to the insufficiency of devices for mechanical ventilation to meet the current demand, it is necessary to adopt measures aimed at preventing complications that may aggravate the patient’s clinical condition and, consequently, increase the average hospital stay and the respective hospital care costs. Therefore, the objective of this study was to discuss, in a concise and practical way, and based on the available literature, the importance of adopting adequate oral hygiene protocols for patients on mechanical ventilation. Based on the data obtained, it was identified that the adoption of effective oral hygiene measures, especially under the supervision of dental professionals, can contribute to the reduction of morbidity and mortality associated with MV, resulting in greater availability of mechanical ventilation equipment. Since such equipment is in great demand during the COVID-19 pandemic, the knowledge and implementation of effective oral hygiene measures will undoubtedly have an impact on improving the quality of care offered to patients, therefore benefiting all those in critical health conditions and assisted in ICUs.

The Oral Complications of COVID-19

“…Severe COVID-19 patients require long-term mechanical ventilation, and these patients will suffer from a large number of oral complications ( Silva et al, 2020 ), such as bad breath, secretions retention in the mouth, mucosal damage, etc. Long-term intubation can easily lead to oral and laryngeal muscle injury, resulting in dysphonia and dysphagia after extubation ( Castillo-Allendes et al, 2021 ).…”

Medidas preventivas de pneumonia associada à ventilação mecânica

“…Desse modo, a higiene bucal deve ser realizada com swab e clorexidina 0,12%, a cada 12 horas. Silva et al (2020) sugestiona que é importante a inclusão da equipe odontológica no atendimento ao paciente melhorando a contribuição da atenção à saúde bucal do paciente em VM, sendo assim, implementando um novo protocolo de higiene bucal com clorexidina 0,12% para prevenção de infecções associadas ao ambiente de UTI.…”

A relação da condição bucal com a transmissibilidade e o agravamento da COVID-19: uma revisão integrativa / The relationship between oral condition and transmissibility and aggravation of COVID-19: an integrative review

“…Devido a isso, grupos de risco foram definidos, e, segundo a Organização Mundial da Saúde (2021), incluem idosos, diabéticos, hipertensos, imunodeficientes e cardiopatas. Porém, estudos recentes apresentaram outros grupos de risco, referentes a doenças sistêmicas, e demonstraram que estes estão diretamente relacionados com a saúde bucal dos pacientes (KAMEL et al, 2021;TAKAHASHI et al, 2021;SILVA et al, 2020;SAMPSON;KAMONA;SAMPSON, 2020). Desse modo, é importante entender quais fatores demonstram essa associação para melhor entendimento da doença e da melhor forma de manejo do paciente.…”