The effects of different oral care protocols on mucosal change in orally intubated patients from an intensive care unit

Hsu, Shu Pen; Liao, Chun‐Sheng; Li, Chung‐Yi; Chiou, Ai Fu

doi:10.1111/j.1365-2702.2010.03515.x

Cited by 25 publications

(47 citation statements)

References 26 publications

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“…Debridement of the tongue via scraping is also advocated in the outpatient setting as a means to reduce halitosis due to bacterial load along the dorsal surface of the tongue (Rosenberg, 1996). With varying degrees of success, saliva substitutes, oral moisturizing agents and various rinses have all been promoted as methods to maintain oral hydration for the ill or intubated patient (DeKeyser et al, 2009;Hsu et al, 2011). A moisturising gel substitute, Oral Balance ® (GlaxoSmithKline, Philadelphia, PA) has been recommended for mucous membranes as it contains two antimicrobial enzymes normally found in saliva, lactoperoxidase and glucose oxidase (Jones, 2005).…”

Section: Literature Reviewmentioning

confidence: 99%

The Bedside Oral Exam and the Barrow Oral Care Protocol: Translating evidence-based oral care into practice

Prendergast

Kleiman

King

2013

Intensive and Critical Care Nursing

104

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Section: Literature Reviewmentioning

confidence: 99%

The Bedside Oral Exam and the Barrow Oral Care Protocol: Translating evidence-based oral care into practice

Prendergast

Kleiman

King

2013

Intensive and Critical Care Nursing

104

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“…In fact, oral care of ICU patients using chlorhexidine (CHX; oral decontamination; Fourrier et al, 2000), using a mouthwash of green tea or boiled water (Hsu, Liao, Li, & Chiou, 2011), and mechanically brushing the oral cavity (toothbrushing; Mori et al, 2006) to dislodge plaque all achieved mixed results in terms of improving mucosal status and reducing organism populations. In fact, oral care of ICU patients using chlorhexidine (CHX; oral decontamination; Fourrier et al, 2000), using a mouthwash of green tea or boiled water (Hsu, Liao, Li, & Chiou, 2011), and mechanically brushing the oral cavity (toothbrushing; Mori et al, 2006) to dislodge plaque all achieved mixed results in terms of improving mucosal status and reducing organism populations.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, when 2% CHX was rubbed on patient oropharyngeal mucosa, 9.8% reported mucosal irritation (Tantipong, Morkchareonpong, Jaiyindee, & Thamlikitkul, 2008). Working to find a more suitable alternative, several studies have suggested the use of a mouthwash of potable water or green tea to improve oral health (Hsu et al, 2011;Wu, & Wei, 2002). Before making credible recommendations for alternatives to CHX for ICU patients (Berry, Davidson, Masters, & Rolls, 2007;Chan, Ruest, Meade, & Cook, 2007;Paju & Scannapieco, 2007), alternatives must be tested using a rigorous RCT design.…”

Section: Introductionmentioning

confidence: 99%

Brushing Teeth With Purified Water to Reduce Ventilator-Associated Pneumonia

Yao

Chang

Maa

et al. 2011

Journal of Nursing Research

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Patients (N = 53) were predominantly male (64.2%), mean age was 60.6 years old, and most had received emergency surgery (75.5%). After 7 days of toothbrushing with purified water, cumulative VAP rates were significantly lower in the experimental (17%) than in the control (71%; p <.05) group. The experimental group also had significantly better scores for oral health (p <.05) and plaque index (p <.01). CONCLUSION/IMPLICATION FOR PRACTICE: Findings suggest that, as an inexpensive alternative to existing protocols, toothbrushing twice daily with purified water reduces VAP and improves oral health and hygiene.

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“…Some oral problems caused by hospitalization have been reported in other studies, including bleeding and changes in the gums and saliva 20,21 . Furthermore, the presence of soft tissue lesions in the oral region may favor bacterial adhesion and proliferation, causing infections 22 and damaging other structures.…”

mentioning

confidence: 99%

Factors associated with oral biofilm in ICU patients with infectious diseases

Damascena

Rodrigues

Costa

et al. 2017

Rev. odontol. UNESP

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ResumoIntrodução: A hospitalização pode provocar deterioração da saúde bucal, repercutindo em todo o corpo. A UTI pode ser um ambiente favorável ao acúmulo de biofilme oral em pacientes críticos. Objetivo: Identificar fatores associados à presença do biofilme em pacientes da UTI de um hospital de doenças infectocontagiosas. Método: Estudo retrospectivo, descritivo e inferencial, com abordagem quantitativa. Os dados foram obtidos em prontuários de pacientes da UTI, de janeiro de 2012 a julho de 2015. O biofilme foi avaliado de acordo com o índice de Greene e Vermillion. Os fatores influentes foram analisados por regressão logística. Resultado: Entre os pacientes da UTI, 69,1% eram homens, 60,7% pacientes com AIDS, 66,3% pacientes na enfermaria, 50,6% intubados e 50,0% sedados. Seus elementos orais eram na maioria normais. As seguintes características foram significativamente associadas a biofilmes orais: alterações orais nos lábios, gengivas, bochechas e palatos e sangramento. Pacientes da enfermaria apresentaram menor risco de apresentar biofilmes. Conclusão: o aumento do acúmulo de biofilme oral foi observado em pacientes com alterações na boca e a procedência do paciente foi associada à presença de biofilme.Descritores: Hospital; paciente; saúde bucal; manifestações orais; biofilme. AbstractIntroduction: Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective: To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method: This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result: Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion: Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.

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The effects of different oral care protocols on mucosal change in orally intubated patients from an intensive care unit

Abstract: Because oral care plays an important role in improving mucosal status, nurses are urged to find new effective oral care methods to further reduce the occurrence of oropharyngeal colonisation and ventilator-associated pneumonia in intubated patients.

Cited by 25 publications

References 26 publications

The Bedside Oral Exam and the Barrow Oral Care Protocol: Translating evidence-based oral care into practice

The Bedside Oral Exam and the Barrow Oral Care Protocol: Translating evidence-based oral care into practice

Brushing Teeth With Purified Water to Reduce Ventilator-Associated Pneumonia

Factors associated with oral biofilm in ICU patients with infectious diseases

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