The effects of an oral care practice on incidence of pneumonia among ventilator patients in ICUs of selected hospitals in Isfahan, 2010

Abstract

• Background: Oral care plays an inevitable role in health and well-being of patients in intensive care units (ICUs). Poor oral care causes colonization of respiratory pathogens and secondary respiratory infections. Ventilator-associated pneumonia occurs in patients on mechanical ventilation for more than 48 hours. It results in prolonged duration of mechanical ventilation, mortality and health expenses. The present study aimed to review the effects of an oral care practice on the incidence of ventilator-associated pneumonia in patients on mechanical ventilation admitted in ICUs.
• Materials and Methods: This was a clinical trial study conducted in the ICUs of selected hospitals in Isfahan during 2010. We randomly divided 54 patients into the intervention and control groups. Intubation was performed during the 48 hours before the study. The intervention group received an oral care practice along with brushing and the control group received routine oral care twice daily. The incidence of ventilator-associated pneumonia was diagnosed through clinical pulmonary infection score (CPIS).
• Findings: The two groups were compared in terms of underlying criteria (APACHE-II). The incidence of ventilator-associated pneumonia did not statistically differ between the intervention and control groups (37% vs. 48.1%; p = 0.41).
• Conclusions: The results of the present study showed that brushing and standard oral care practice had no effects on ventilator-associated pneumonia. Therefore, the incidence of such complication might be affected by many different factors.
• Key words: Oral hygiene, tooth brushing, ventilator-associated pneumonia, intratracheal intubation