Cargando…

Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review

Introduction: Oropharyngeal colonization with pathogenic organisms contributes to the development of ventilator-associated pneumonia (VAP) in intensive care units (ICUs). Oral hygiene care (OHC) is a very effective method for reducing the risk of VAP in these patients. This study aimed to evaluate r...

Descripción completa

Detalles Bibliográficos
Autores principales: Keykha, Aliakbar, Ramezani, Monir, Amini, Shahram, Karimi Moonaghi, Hossein
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tabriz University of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526792/
https://www.ncbi.nlm.nih.gov/pubmed/36247039
http://dx.doi.org/10.34172/jcs.2021.029
_version_ 1784800956583510016
author Keykha, Aliakbar
Ramezani, Monir
Amini, Shahram
Karimi Moonaghi, Hossein
author_facet Keykha, Aliakbar
Ramezani, Monir
Amini, Shahram
Karimi Moonaghi, Hossein
author_sort Keykha, Aliakbar
collection PubMed
description Introduction: Oropharyngeal colonization with pathogenic organisms contributes to the development of ventilator-associated pneumonia (VAP) in intensive care units (ICUs). Oral hygiene care (OHC) is a very effective method for reducing the risk of VAP in these patients. This study aimed to evaluate recent OHC strategies to decrease VAP. Methods: Randomized clinical trials (RCTs) published in the PubMed, Scopus, Embase, Cochrane Library, and Web of Science databases from inception to September 10, 2020 were reviewed to compare the effects of selective oropharyngeal decontamination (SOD) on the incidence of VAP in adult patients requiring mechanical ventilation. Results: Out of a total of 1098 articles reviewed, 17 eligible studies were included for final analysis. The results showed that the use of chlorhexidine for oropharyngeal decontamination reduces the incidence of VAP. However, it had a small effect on gram-negative resistant bacteria. Also, it was observed that the combined use of colistin and chlorhexidine was more effective than chlorhexidine alone in preventing VAP. The results of studies on the use of toothbrushes to reduce the incidence of pneumonia are unclear since they used chlorhexidine at the same time. However, tooth brushing is one of the best ways to maintain oral hygiene. Using povidoneiodine, Nanosil, and non-absorbable topical antibiotics reduced the incidence of VAP, while Iseganan did not show a significant effect in this regard. Conclusion: The prophylactic use of topical bactericidal agents in critically-ill patients is effective in reducing the incidence of VAP. However, the use of non-absorbable topical antibiotics is more effective than other methods in oropharyngeal decontamination.
format Online
Article
Text
id pubmed-9526792
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Tabriz University of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-95267922022-10-14 Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review Keykha, Aliakbar Ramezani, Monir Amini, Shahram Karimi Moonaghi, Hossein J Caring Sci Review Article Introduction: Oropharyngeal colonization with pathogenic organisms contributes to the development of ventilator-associated pneumonia (VAP) in intensive care units (ICUs). Oral hygiene care (OHC) is a very effective method for reducing the risk of VAP in these patients. This study aimed to evaluate recent OHC strategies to decrease VAP. Methods: Randomized clinical trials (RCTs) published in the PubMed, Scopus, Embase, Cochrane Library, and Web of Science databases from inception to September 10, 2020 were reviewed to compare the effects of selective oropharyngeal decontamination (SOD) on the incidence of VAP in adult patients requiring mechanical ventilation. Results: Out of a total of 1098 articles reviewed, 17 eligible studies were included for final analysis. The results showed that the use of chlorhexidine for oropharyngeal decontamination reduces the incidence of VAP. However, it had a small effect on gram-negative resistant bacteria. Also, it was observed that the combined use of colistin and chlorhexidine was more effective than chlorhexidine alone in preventing VAP. The results of studies on the use of toothbrushes to reduce the incidence of pneumonia are unclear since they used chlorhexidine at the same time. However, tooth brushing is one of the best ways to maintain oral hygiene. Using povidoneiodine, Nanosil, and non-absorbable topical antibiotics reduced the incidence of VAP, while Iseganan did not show a significant effect in this regard. Conclusion: The prophylactic use of topical bactericidal agents in critically-ill patients is effective in reducing the incidence of VAP. However, the use of non-absorbable topical antibiotics is more effective than other methods in oropharyngeal decontamination. Tabriz University of Medical Sciences 2021-09-07 /pmc/articles/PMC9526792/ /pubmed/36247039 http://dx.doi.org/10.34172/jcs.2021.029 Text en © 2022 The Author(s). https://creativecommons.org/licenses/by-nc/4.0/This work is published by Journal of Caring Sciences as an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.
spellingShingle Review Article
Keykha, Aliakbar
Ramezani, Monir
Amini, Shahram
Karimi Moonaghi, Hossein
Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review
title Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review
title_full Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review
title_fullStr Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review
title_full_unstemmed Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review
title_short Oropharyngeal Decontamination for Prevention of VAP in Patients Admitted to Intensive Care Units: A Systematic Review
title_sort oropharyngeal decontamination for prevention of vap in patients admitted to intensive care units: a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526792/
https://www.ncbi.nlm.nih.gov/pubmed/36247039
http://dx.doi.org/10.34172/jcs.2021.029
work_keys_str_mv AT keykhaaliakbar oropharyngealdecontaminationforpreventionofvapinpatientsadmittedtointensivecareunitsasystematicreview
AT ramezanimonir oropharyngealdecontaminationforpreventionofvapinpatientsadmittedtointensivecareunitsasystematicreview
AT aminishahram oropharyngealdecontaminationforpreventionofvapinpatientsadmittedtointensivecareunitsasystematicreview
AT karimimoonaghihossein oropharyngealdecontaminationforpreventionofvapinpatientsadmittedtointensivecareunitsasystematicreview