The effect of different oral hygiene treatments on the occurrence of ventilator associated pneumonia (VAP) in ventilated patients.

BACKGROUND

We compared the incidence of ventilator associated pneumonia (VAP) among patients treated with comprehensive oral care to those treated with conventional methods of oral care.

METHODS

We conducted a prospective, controlled study in an intensive care unit of 90 ventilated patients. Patients in the study group received a comprehensive oral hygiene treatment regimen that involved tooth brushing, suctioning, sodium bicarbonate, rinsing with an antiseptic solution containing 1.5% hydrogen peroxide and a mouth moisturiser. Patients in the control group received a more conventional treatment that included cleaning with a sponge and atraumatic clamp, and rinsing with a 0.2% solution of chlorhexidine gluconate.

RESULTS

Among the 90 patients admitted to the ICU, 8.9% of the study group developed VAP compared with 33.3% of the control group (< 0.004). The development of VAP per 1,000 ventilation days was 10.2 in the study group, and 29.5 in the control group (< 0.06). The mean number of ventilation days and the mean number of hospitalisation days were also lower in the study group.

CONCLUSIONS

In patients who are ventilated, a comprehensive oral hygiene treatment regimen that includes tooth brushing, suctioning and rinsing with an antiseptic is more effective in preventing VAP than more conventional protocols.