Gershonovitch Ron, Yarom Noam, Findler Mordechai
Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel.
School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
SN Compr Clin Med. 2020;2(6):727-733. doi: 10.1007/s42399-020-00319-8. Epub 2020 May 30.
To assess the effects of various oral care methods on the incidence of VAP in patients receiving mechanical ventilation in intensive care units, an exhaustive literature search was undertaken using MEDLINE as well as a manual review of the relevant literature and citations. Eight publications were selected for this review. The primary endpoint was the incidence of VAP. Different oral care methods for preventing VAP were the subject of this review. Two studies that were reviewed in this article showed significant statistical difference between the intervention group and the control group regarding different oral care for lowering the incidence of VAP. The rest of the studies showed no significant statistical difference between the intervention group and the control group, but showed the importance of meticulous oral hygiene in those patients. Mechanically ventilated patients who suffer from poor oral hygiene are exposed to the harmful accumulation of oral plaque and the initiation of VAP. Proper oral care by qualified care givers can reduce the incidence of VAP. Proper oral care needs to be considered part of the medical treatment plan when a patient is admitted to the ICU to lower the incidence rates of VAP. Oral care treatment of ventilated patients in the intensive care units, for prevention of ventilator-associated pneumonia, is with high clinical relevance, decreasing morbidity and mortality in the ICU. We recommend that ICU medical teams will plan a protocol of oral care treatment, based on our article results, and implement it as part of the daily routine.
为评估各种口腔护理方法对重症监护病房接受机械通气患者发生呼吸机相关性肺炎（VAP）的影响，我们使用MEDLINE进行了全面的文献检索，并对手头相关文献及参考文献进行了回顾。本次综述选取了8篇出版物。主要终点是VAP的发生率。本综述的主题是预防VAP的不同口腔护理方法。本文回顾的两项研究显示，干预组和对照组在采用不同口腔护理方法降低VAP发生率方面存在显著统计学差异。其余研究显示干预组和对照组之间无显著统计学差异，但表明了对这些患者进行细致口腔卫生护理的重要性。口腔卫生差的机械通气患者易发生有害的牙菌斑积聚并引发VAP。由合格护理人员进行适当的口腔护理可降低VAP的发生率。当患者入住重症监护病房时，应将适当的口腔护理视为医疗治疗计划的一部分，以降低VAP的发生率。重症监护病房中对通气患者进行口腔护理治疗以预防呼吸机相关性肺炎具有高度临床相关性，可降低重症监护病房的发病率和死亡率。我们建议重症监护病房医疗团队根据本文结果制定口腔护理治疗方案，并将其作为日常工作的一部分加以实施。
