Oral Antiseptiklerin Ventilatör İlişkili Pnömoninin Önlenmesine Etkisi: Bibliyometrik Çalışma

Year 2025, Volume: 8 Issue: 2, 95 - 103, 18.07.2025

Banu Uygun-can

Abstract

Amaç: Ventilatörle ilişkili pnömoni (VAP), yoğun bakım ünitelerinde mekanik ventilasyon uygulanan hastalarda önemli bir nozokomiyal enfeksiyon olup morbidite, mortalite ve hastanede yatış süresini artırmaktadır. Ağız hijyeninin sağlanması, VAP insidansını azaltmak için yaygın olarak kullanılan bir önlem olmakla birlikte, klorheksidin (CHX) gibi antiseptik ajanların etkinliği konusunda literatürde çelişkili sonuçlar mevcuttur. Bu çalışmanın amacı, CHX ve alternatif antiseptik ajanların VAP insidansı, mortalite ve hastanede kalış süresi üzerindeki etkilerini bibliyometrik analiz yöntemiyle incelemek ve alandaki bilimsel araştırma eğilimlerini belirlemektir.
Gereç ve Yöntem: Bu bibliyometrik analiz, 2000-2024 yılları arasında Web of Science, Scopus ve PubMed veri tabanlarında yayımlanan çalışmaların sistematik olarak taranmasıyla gerçekleştirilmiştir. Dahil edilme kriterleri, ventilatörle ilişkili pnömoni üzerine ağız antiseptiklerinin etkisini inceleyen randomize kontrollü çalışmalar (RKÇ)’dır.
Bulgular: Analiz edilen çalışmalar, CHX’in bazı durumlarda VAP insidansını azalttığını gösterirken, bazı çalışmalarda anlamlı bir etkisinin olmadığını ortaya koymuştur. Alternatif ajanlar arasında ozonlu su, povidon-iyod ve bitkisel içerikli gargaraların VAP önlenmesinde benzer veya daha fazla etkinlik gösterdiği belirlenmiştir. Elde edilen bulgular, VAP önleme protokollerinde tek başına CHX kullanımının yeterli olmayabileceğini ve alternatif antiseptik ajanların değerlendirilmesi gerektiğini göstermektedir. Özellikle ozonlu su, povidon-iyot ve bitrkisel içerikli ajanlar VAP insidansını azaltma konusunda umut verici olabilir.
Sonuç: Bibliyometrik analiz sonuçları, VAP önlenmesine yönelik araştırmaların giderek artan bir eğilim gösterdiğini ve gelecekte daha büyük ölçekli, ortak metodoloji kullanan, çok merkezli randomize kontrollü çalışmaların yapılmasının gerekliliğini ortaya koymaktadır.

Keywords

Yoğun bakım ünitesi, Ventilatörle ilişkili pnömoni,, Antiseptik gargaralar, Ağız hijyeni, Diş plağı kolonizasyonu

EFFECT OF ORAL ANTISEPTICS ON PREVENTION OF VENTILATOR-ASSOCIATED PNEUMONIA: A BIBLIOMETRIC STUDY

Abstract

Aim: Ventilator-associated pneumonia (VAP) is an important nosocomial infection in mechanically ventilated patients in intensive care units and increases morbidity, mortality, and length of hospital stay. Maintenance of oral hygiene is a widely used preventive measure to reduce the incidence of VAP; however, the efficacy of antiseptic agents such as chlorhexidine (CHX) has shown contradictory results in the literature. This study aims to evaluate the effects of CHX and alternative antiseptic agents on the incidence of VAP, mortality, and length of hospital stay through bibliometric analysis and to determine scientific research trends in this area.
Materials and Methods: This bibliometric analysis was conducted by systematically searching the Web of Science, Scopus, Embase, and PubMed databases for studies published between 2000 and 2024. Inclusion criteria included randomized controlled trials (RCTs) investigating the effects of oral antiseptics on ventilator-associated pneumonia.
Results: The analyzed studies showed that CHX reduces the incidence of VAP in some cases, while no significant effect is found in others. Among the alternative agents, ozonated water, povidone-iodine and herbal-based mouthwashes showed similar or greater efficacy in preventing VAP. The findings suggest that the use of CHX alone may not be sufficient in VAP prevention protocols and that alternative antiseptic agents should be considered. In particular, ozonated water and povidone-iodine and herbal-based agents may be promising in reducing the incidence of VAP.
Conclusion: The results of the bibliometric analysis indicate an increasing trend in the research of oral antiseptics in VAP prevention and emphasize the need for larger-scale, multicenter randomized controlled trials using common methodology in the future.

Keywords

Intensive care unit, Ventilator-associated pneumonia, Antiseptic mouthwashes, Oral hygiene, Dental plaque colonization

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