Effectiveness of oral care solutions to prevent VAP in patients on mechanical ventilation: Systematic review and meta-analysis
Yıl 2024,
Cilt: 7 Sayı: 2, 172 - 190, 30.09.2024
Sercan Özdemir
,
Gülengün Türk
,
Zekiye Karaçam
Öz
This study was conducted to determine the effect of different oral care solutions on ventilator-associated pneumonia in patients under mechanical ventilation. To evaluate the effectiveness of oral care solutions in preventing VAP in patients under mechanical ventilation, randomized controlled studies were searched from databases such as PubMed, EBSCO, Embase, Web of Science, Clinical Trials and Turkey’s National electronic databases. Overall, a total of 10 randomized controlled experimental studies from 2028 scans were included in the analysis. The total sample size of the studies was 777 (intervention group: 417; control group: 360). In this meta-analysis, comprehensive oral care was effective in reducing the likelihood of VAP infection, but did not provide a clear conclusion as to which solution was more effective. Based on these results, stronger evidence is needed to reach to a conclusion about which of the oral care solutions are more effective in preventing VAP in patients on mechanical ventilation.
Etik Beyan
Not applicable as this is systematic review, this paper was provided based on researching in global databases.
Destekleyen Kurum
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Kaynakça
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Mekanik Ventilasyon Desteğindeki Hastalarda Vip Önlemek İçin Kullanılan Ağız Bakım Solüsyonlarının Etkinliği: Sistematik İnceleme ve Meta-Analiz
Yıl 2024,
Cilt: 7 Sayı: 2, 172 - 190, 30.09.2024
Sercan Özdemir
,
Gülengün Türk
,
Zekiye Karaçam
Öz
Bu araştırma mekanik ventilasyon desteğindeki hastalarda farklı ağız bakım solüsyonlarının ventilatörle ilişkili pnömoni üzerine etkisini belirlemek amacıyla yapılmıştır. Mekanik ventilasyon desteğindeki hastalarda ağız bakımı solüsyonlarının VİP'i önlemedeki etkinliğini değerlendirmek için PubMed, EBSCO, Embase, Web of Science, Clinical Trials gibi veri tabanlarından ve Türkiye Ulusal elektronik veri tabanlarından randomize kontrollü çalışmalar tarandı. Genel olarak, 2028 taramadan elde edilen toplam 10 randomize kontrollü deneysel çalışma analize dahil edildi. Çalışmaların toplam örneklem büyüklüğü 777'dir (müdahale grubu: 417; kontrol grubu: 360). Bu meta-analizde kapsamlı ağız bakımı VİP enfeksiyonu olasılığını azaltmada etkiliydi ancak hangi çözümün daha etkili olduğu konusunda net bir sonuca varılamadı. Bu sonuçlara dayanarak, mekanik ventilasyondaki hastalarda VİP'i önlemede hangi ağız bakım çözümlerinin daha etkili olduğu konusunda bir sonuca varmak için daha güçlü kanıtlara ihtiyaç vardır.
Kaynakça
- Abidia, RF. (2007). Oral care in the intensive care unit: A review. The Journal of Contemporary Dental Practice, 8 (1), 1-8.
- Akca O, Bautista AF and Lenhardt R. (2014). Is elderly ICU patient more prone to pneumonia? Critical Care Medicine, 42(3):742-744. https://doi.org/10.1097/CCM.0000000000000156
- Al-Ayed M.S.Z., Asaad A.M., Qureshi M.A., Attia H.G and AlMarrani A.H. (2016). Antibacterial activity of Salvadora persica L. (Miswak) extracts against multidrug resistant bacterial clinical isolates. Evidence-Based Complementary and Alternative Medicine, https://doi.org/10.1155/2016/7083964.
- Anupunpisit V, Chuanchaiyakul S, Petchpiboolthai H, Jungudomjaroen S and Stapanavatr W. (2004). Characterization of infected diabetic wound after ozonated water therapy. Journal of Medicine and Health Sciences, 11(1, 2).
- Ayala-Núñez NV, Villegas HHL, Turrent LdCI and Padilla CR. (2009). Silver nanoparticles toxicity and bactericidal effect against methicillin-resistant Staphylococcus aureus: nanoscale does matter. Nanobiotechnology. 5(1-4):2–9. https://doi.org/10.1007/s12030-009-9029-1
- Berry AM, Davidson PM, Masters J, Rolls K and Ollerton R. (2011). Effects of three approaches to standardized oral hygiene to reduce bacterial colonization and ventilator associated pneumonia in mechanically ventilated patients: a randomised control trial. International Journal of Nursing Studies, 48:686–8. https://doi.org/10.1016/j.ijnurstu.2010.11.004
- Berry AM. (2013). A comparison of Listerine® and sodium bicarbonate oral cleansing solutions on dental plaque colonisation and incidence of ventilator associated pneumonia in mechanically ventilated patients: a randomised control trial. Intensive and Critical Care Nursing, 29(5):275-81. https://doi.org/10.1016/j.iccn.2013.01.002
- Cabov, T., Macan, D., Husedzinović, I., Skrlin-Subić, J., Bosnjak, D., Sestan-Crnek, S., Perić, B., Kovac, Z., and Golubović, V. (2010). The impact of oral health and 0.2% chlorhexidine oral gel on the prevalence of nosocomial infections in surgical intensive-care patients: a randomized placebo-controlled study. Wiener klinische Wochenschrift, 122(13-14), 397–404. https://doi.org/10.1007/s00508-010-1397-y
- Centers for Disease Control and Prevention. (2024). Pneumonia (Ventilator-associated [VAP] and nonventilator-associated Pneumonia [PNEU]) Event https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf. 6-19
- Cesar J, Sumita TC, Junqueira JC, Jorge AO and do Rego MA. (2012). Antimicrobial effects of ozonated water on the sanitization of dental instruments contaminated with E. coli, S. aureus, C. albicans, or the spores of B. atrophaeus. Journal of Infection and Public Health, 5(4):269–274. https://doi.org/10.1016/j.jiph.2011.12.007
- Chlebicki, M. P., and Safdar, N. (2007). Topical chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. Critical care medicine, 35(2), 595–602. https://doi.org/10.1097/01.CCM.0000253395.70708.AC
- Choi K, Lee SS, Oh SJ, Lim SY, Lim SY, Jeon WK, Oh TY and Kim JW. (2007). The effect of oral glutamine on 5-fluorouracil/ leucovorin-induced mucositis/stomatitis assessed by intestinal permeability test. Clinical Nutrition, 26:57–62. https://doi.org/10.1016/j.clnu.2006.07.003
- Cockerham MB, Weinberger BB, Lerchie SB (2000): Oral glutamine for the prevention of oral mucositis associated with high-dose paclitaxel and melphalan for autologous bone marrow transplantation. Ann Pharmacother;34: 300–3.
- Cooper NJ, Kendrick D, Achana F, Dhiman P, He Z, Wynn P, Cozannet EL, Saramago P and Sutton AJ. (2012). Network meta-analysis to evaluate the effectiveness of interventions to increase the uptake of smoke alarms. Epidemiologic Reviews, 34:32–45. https://doi.org/10.1093/epirev/mxr015
- Coşkun, A. M., Topdağ, E and Kara, A. (2017). Effectiveness of oral hygiene and two different antiseptic solutions used in the prevention of ventilator - associated pneumonia (VAP) in pediatric intensive care units. Yoğun Bakım Hemşireliği Dergisi, 21(2), 28-35.
- Deeks, J. J., Higgins, J. P. T., and Altman, D. G. (editors). Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., and Welch, V. A. (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). Cochrane, 2021. pp. 243-296 Available from www.training.cochrane.org/handbook.
- Deschepper M, Waegeman W, Eeckloo K, Vogelaers D and Blot S. (2018). Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study. Intensive Care Medicine, 44(7), 1017-1026. doi: 10.1007/s00134-018-5171-3
- Enwere EN, Elofson KA, Forbes RC and Gerlach AT. (2016). Impact of chlorhexidine mouthwash prophylaxis on probable ventilator-associated pneumonia in a surgical intensive care unit. International Journal of Critical Illness and Injury Science, 6(1), 3. doi: 10.4103/2229-5151.177368
- Grap, M. J., Munro, C. L., Hamilton, V. A., Elswick, R. K., Jr, Sessler, C. N., and Ward, K. R. (2011). Early, single chlorhexidine application reduces ventilator-associated pneumonia in trauma patients. Heart and lung: the journal of critical care, 40(5), e115–e122. https://doi.org/10.1016/j.hrtlng.2011.01.006
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