The Effect Of Oral Care Given To Patients On Mechanical Ventilatory Support By Two Different Methods On Bacterial Colonization In Oral Mucosa And Oral Health

Year 2019, Volume: 9 Issue: 4, 321 - 331, 31.12.2019

Ayşe Tali Elif Karahan Füsun Cömert

https://doi.org/10.16899/jcm.628392

Abstract

Aim: The aim of the study was to
examine oral care given to the patients on mechanical ventilatory support by
two different methods on bacterial colonization and oral health.

Methods: This study had a design
including an experimental and a control group. Sample was composed of 30
patients who had mechanical ventilatory support less than 24 hours. Patients in
the experimental group were applied toothbrush and serum physiological; and
control group was applied oral care by abeslang and a sponge soaked with NaHCO₃. Both groups were given
oral care four times a day for four days. Oral health was evaluated by “oral
assessment scale”, and bacterial colonization was assessed based on
bacteriological culture results of samples taken by cotton swab at days 1 and
4.

Results: It was found that almost
half of the patients in both groups had insufficient saliva that was more
viscous than normal; and dental plaques were decreased among the patients in
the experimental group. In terms of bacteria in the oral mucosa, no
statistically significant differences were found between the groups based on
the comparison of culture results from days 1 and 4. It was found that both
methods used for oral care were effective; and they had no superiority over
each other.

Conclusions: It was concluded that
application of regular oral care for the patients on mechanical ventilatory
support as part of care protocols decreased bacterial colonization and had a
protective and improving effect on oral health. 

Keywords

Oral care, Mechanical ventilator, Oral mucosa, Toothbrush, Intensive care

Supporting Institution

Zonguldak Bulent Ecevit University Scientific Research Projects Coordinator

Project Number

2016-19093093-01

MEKANİK VENTİLATÖR DESTEĞİNDEKİ HASTALARA İKİ FARKLI YÖNTEMLE VERİLEN AĞIZ BAKIMININ ORAL MUKOZADAKİ BAKTERİYEL KOLONİZASYON VE AĞIZ SAĞLIĞI ÜZERİNE ETKİSİ

Abstract

Amaç: Mekanik ventilatör
desteğindeki hastalarda iki farklı yöntemle verilen ağız bakımının oral mukozadaki
bakteriyel kolonizasyon ve ağız sağlığı üzerine olan etkisininincelenmesidir.

Yöntem: Araştırma, deneysel
kontrollü çalışma tasarımı ile yürütülmüştür. Bir Sağlık Uygulama ve Araştırma
Merkezi’nin iki farklı yoğun bakımında 26.03.2017-20.02.2018 tarihleri arasında
gerçekleştirilmiştir. Örneklemi, mekanik ventilatör desteği başlangıcından 24
saat geçmemiş olan 30 hasta oluşturmuştur. Hastalar deney ve kontrol olmak
üzere iki gruba ayrılmıştır.  Deney
grubundaki hastalara serum fizyolojik ve diş fırçası ile kontrol grubundaki
hastalara NaHCO₃ ile ıslatılmış spanç
ve abeslang yardımıyla ağız bakımı uygulanmıştır. Her iki gruba da dört gün
süreyle günde dört kez ağız bakımı verilmiştir. Ağız sağlığı “ağız
değerlendirme ölçeği” ile, bakteri kolonizasyonu ise 1. ve 4. gün pamuklu
eküvyon çubukla ağızdan alınan örneklerin bakteriyolojik kültür sonuçlarına
göre değerlendirilmiştir. Araştırmanın gerçekleştirilebilmesi için etik izin,
kurumdan yazılı izin, hasta vasisinden aydınlatılmış onam alınmıştır. Verilerin
değerlendirilmesinde Pearson Ki-Kare testi, t testi, Mann Whitney testi ve
FisherExact test; McNemar testi kullanılmıştır.  

Bulgular: Hastalara
verilen dört günlük ağız bakımı sonucunda her iki grupta da hastaların yarısına
yakınında tükürüğünün yetersiz ve normalden daha yoğun olduğu; deney grubundaki
hastaların diş plaklarında azalma olduğu görülmüştür. Ağız mukozasında bulunan
bakteriler bakımından, 1. ve 4. gün alınan kültür sonuçlarının
karşılaştırılmasına göre gruplar arasında istatistiksel olarak anlamlı
farklılığın olmadığı belirlenmiştir. Ağız bakımında kullanılan serum fizyolojik
ve diş fırçası ile NaHCO₃ ile
ıslatılmış spanç ve abeslang yöntemlerinin etkin ancak birbirine
üstünlüklerinin olmadığı saptanmıştır.

Sonuç: Mekanik ventilatör desteğindeki
hastalar için bakım protokolleri çerçevesinde düzenli ağız bakımı
yapılmasının bakteri kolonizasyonunu azalttığı, ağız sağlığını koruyucu ve
geliştirici etkisi görülmüştür.

Keywords

Ağız bakımı, Mekanik ventilatör, Ağız mukozası, Diş fırçası, Yoğun bakım

Project Number

2016-19093093-01

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