Randomized Controlled Trial and Meta-analysis of Oral Decontamination with 2% Chlorhexidine Solution for the Prevention of Ventilator-Associated Pneumonia

Tantipong, Hutsaya; Morkchareonpong, Chantana; Jaiyindee, Songyod; Thamlikitkul, Visanu

doi:10.1086/526438

Cited by 208 publications

(201 citation statements)

References 18 publications

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“…Chlorhexidine at varying concentrations, however, has been evaluated in more than 11 trials. Impacts on VAP rates have been variable: three reported decreases [64][65][66] while the other eight did not [67][68][69][70][71][72][73][74]. One trial reported a decrease in antibiotic usage for patients treated with chlorhexidine [67].…”

Section: Oral Antiseptics and Antibioticsmentioning

confidence: 99%

Prevention of ventilator-associated pneumonia

Klompas¹

2010

Expert Review of Anti-infective Therapy

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Section: Oral Antiseptics and Antibioticsmentioning

confidence: 99%

Prevention of ventilator-associated pneumonia

Klompas¹

2010

Expert Review of Anti-infective Therapy

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“…A recent meta-analysis concluded that use of oral chlorhexidine might be effective in preventing lower respiratory tract infections in patients receiving mechanical ventilation for up to 48 hours, although its impact in preventing late-onset VAP requires further research. 8 Remarkably, none of those meta-analyses, or the study by Tantipong et al 1 demonstrated any impact on mortality.…”

Section: E T T E R S T O T H E E D I T O R Prevention Of Ventilatormentioning

confidence: 96%

“…To the Editor-We read with interest the article by Tantipong et al 1 on the use of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia (VAP). We believe that their study has some important limitations and that the authors' conclusion that oral chlorhexidine is an effective and safe method for VAP prevention is not supported by the results.…”

Section: E T T E R S T O T H E E D I T O R Prevention Of Ventilatormentioning

confidence: 99%

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Prevention of Ventilator-Associated Pneumonia by Use of Oral Chlorhexidine

Silvestri¹,

Saene

Milanese³

et al. 2009

Infect. Control Hosp. Epidemiol.

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“…(42) The literature reports a wide variety of treatment regimens using chlorhexidine, including variations in concentration (0.2%, 0.12% and 2%), site of application, form of presentation (oral rinse or gel) and application techniques. (32,42,43) Studies involving cardiac surgery patients at a low risk for VAP reported that chlorhexidine at 0.12% was effective; however, higher concentrations might be required for more heterogeneous populations in a hospital environment, since the use of chlorhexidine at 2% in these populations seemed to produce better results. (32) The association between oral decontamination using topical antiseptic agents and the time spent in the ICU, mortality or duration of MV is not always evident; however, a reduction in the incidence of pneumonia has been observed in all studies.…”

Section: Prevention Of Nosocomial Pneumonia: Importance Of Oral Hygiementioning

confidence: 99%

Pneumonia nosocomial: importância do microambiente oral

2009

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on average, 5-9 days the length of hospital stay of patients, nosocomial pneumonia markedly increases hospital costs. (5)(6)(7)(8) The use of oral antiseptic and antimicrobial agents to prevent nosocomial pneumonia has been widely studied and, based on what has been reported, the present study aimed to review the literature focusing on how oral microorganisms can influence the development of nosocomial pneumonia and on how the frequency of nosocomial pneumonia can be reduced by changing the oral environment. DefinitionsPneumonia is an acute lung infection, which can produce respiratory signs and symptoms, such as cough, short and fast breathing, production of secretion and chest pain, as well as non-specific systemic symptoms, such as fever, IntroductionPeriodontal medicine appeared based on studies that reported the direct relationship between periodontal disease and a number of systemic morbidities, such as atherosclerosis, acute myocardial infarction, preterm birth, low birth weight, respiratory problems, gastritis, endocarditis and bacteremia.(1-3) Within this group of diseases, nosocomial pneumonia has been increasingly studied, and the relationship between nosocomial pneumonia and microorganisms from the oral cavity has been increasingly acknowledged.Patients submitted to cardiac surgery have a particularly high risk of developing nosocomial pneumonia; in these patients, the incidence of nosocomial pneumonia can be as high as 20%, and the disease is significantly associated with mortality.(4) The risk of developing nosocomial pneumonia increases with the need for mechanical ventilation and, in addition to prolonging, AbstractNosocomial pneumonia, especially ventilator-associated pneumonia, is a common infection in ICUs. The main etiologic factors involve colonizing and opportunistic bacteria from the oral cavity. Oral hygiene measures, including the use of oral antiseptic agents, such as chlorhexidine, have proven useful in reducing its incidence. The objective of this article was to review the literature on the importance of the oral environment in the development of nosocomial pneumonia.Keywords: Intensive care; Oral hygiene; Cross infection; Pneumonia. ResumoA pneumonia nosocomial, em especial aquela associada à ventilação mecânica, é uma infecção frequente nas UTIs. Seus principais fatores etiológicos incluem bactérias colonizadoras e oportunistas da cavidade oral. Manobras de higiene oral, com o uso de antissépticos orais, como a clorexidina, têm se mostrado úteis na diminuição de sua incidência. O objetivo deste trabalho foi revisar a literatura sobre a importância do microambiente oral no desenvolvimento da pneumonia nosocomial.

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Randomized Controlled Trial and Meta-analysis of Oral Decontamination with 2% Chlorhexidine Solution for the Prevention of Ventilator-Associated Pneumonia

Abstract: Oral decontamination with 2% chlorhexidine solution is an effective and safe method for preventing VAP in patients who receive mechanical ventilation.

Cited by 208 publications

References 18 publications

Prevention of ventilator-associated pneumonia

Prevention of ventilator-associated pneumonia

Prevention of Ventilator-Associated Pneumonia by Use of Oral Chlorhexidine

Pneumonia nosocomial: importância do microambiente oral

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