Department of Surgery Sciences, Intensive Care Unit, General Hospital of the State University of Campinas, Campinas, SP, Brazil.
Department of Surgery Sciences, Intensive Care Unit, General Hospital of the State University of Campinas, Campinas, SP, Brazil.
Am J Infect Control. 2022 Sep;50(9):1055-1059. doi: 10.1016/j.ajic.2021.11.026. Epub 2021 Dec 7.
This study aimed to evaluate a multidisciplinary intensive oral health protocol, proposed and applied by a dentist, in an adult Intensive Care Unit (ICU), in regards to the prevention of Ventilator-associated Pneumonia (VAP), compared with retrospective data.
4,103 patients admitted to the adult ICU from January 2013 to December 2017 and selected patients who were under mechanical ventilation with an orotracheal tube for at least 48 hours. These patients were compared before (Baseline Group) and after (Intervention Group) the hygiene protocol established and carried out by a multidisciplinary team led by a dentist. The Baseline Group, from January 2013 to May 2015, 213 patients, and the Intervention Group, from June 2015 to December 2017, 137 patients.
Forty-five patients (21.12%) in the Baseline Group and 5 patients (3.65%) in the Intervention Group developed VAP (P < .05). Twenty-two patients (10.33%) died due to VAP in the Baseline Group, and 1 patient (0.73%) died due to VAP (P < .05) in the Intervention Group. The mortality rate of VAP was 48.89% for Baseline Group and 20.00% for Intervention Group (P > .05).
The study showed better outcomes when patients' oral health is led, evaluated and treated by a dentist in the ICU. The dental care intervention contributed to the reduction of VAP episodes and deaths due to VAP.
本研究旨在评估由一名牙医提出并应用的多学科强化口腔健康方案在成人重症监护病房（ICU）预防呼吸机相关性肺炎（VAP）方面的效果，与回顾性数据进行比较。
选取 2013 年 1 月至 2017 年 12 月期间入住成人 ICU 并接受机械通气治疗至少 48 小时的 4103 名患者。将这些患者分为基线组（2013 年 1 月至 2015 年 5 月，213 例）和干预组（2015 年 6 月至 2017 年 12 月，137 例），比较两组在多学科团队（由牙医领导）制定和实施口腔卫生方案前后的情况。
基线组中 45 例（21.12%）患者发生 VAP，干预组中 5 例（3.65%）患者发生 VAP（P<0.05）。基线组中有 22 例（10.33%）患者因 VAP 死亡，干预组中有 1 例（0.73%）患者因 VAP 死亡（P<0.05）。基线组的 VAP 死亡率为 48.89%，干预组的 VAP 死亡率为 20.00%（P>0.05）。
研究表明，在 ICU 中由牙医主导、评估和治疗患者口腔健康状况可以获得更好的结果。牙医的口腔护理干预有助于减少 VAP 发作和 VAP 相关死亡。
