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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
https://doi.org/10.52538/iduhes.1466964

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

  • 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.
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  • 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
  • Gutiérrez, J. M. M., Borromeo, A. R., Dueño, A. L., Paragas, E. D., Ellasus, R. O., Abalos Fabia, R. S., Abriam, J.A., Sonido, A.E., Hernandez, M.A., Generale, A.J.A., Sombillo, R.C., Lacanaria, M.G.C., Centeno, M.M., Laoingco, J.R.C and Domantay, J.A.A (2019). Clinical epidemiology and outcomes of ventilator associated pneumonia in critically ill adult patients: protocol for a large-scale systematic review and planned meta-analysis. Systematic Reviews, 8(1), 180. https://doi.org/10.1186/s13643-019-1080-y
  • Hanifi, N., Masoumi, M., Jamshidi, M.R and Faghihzadeh, S. (2017). The Effect of Ozonated Water and Chlorhexidine Gluconate on Prevention of Ventilator-Associated Pneumonia: A Double-Blind, Randomized, Clinical Trial. Iranian Red Crescent Medical Journal, 19(10):e60576. 1-8. https://doi.org/10.5812/ircmj.60576
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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
https://doi.org/10.52538/iduhes.1466964

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
  • Gutiérrez, J. M. M., Borromeo, A. R., Dueño, A. L., Paragas, E. D., Ellasus, R. O., Abalos Fabia, R. S., Abriam, J.A., Sonido, A.E., Hernandez, M.A., Generale, A.J.A., Sombillo, R.C., Lacanaria, M.G.C., Centeno, M.M., Laoingco, J.R.C and Domantay, J.A.A (2019). Clinical epidemiology and outcomes of ventilator associated pneumonia in critically ill adult patients: protocol for a large-scale systematic review and planned meta-analysis. Systematic Reviews, 8(1), 180. https://doi.org/10.1186/s13643-019-1080-y
  • Hanifi, N., Masoumi, M., Jamshidi, M.R and Faghihzadeh, S. (2017). The Effect of Ozonated Water and Chlorhexidine Gluconate on Prevention of Ventilator-Associated Pneumonia: A Double-Blind, Randomized, Clinical Trial. Iranian Red Crescent Medical Journal, 19(10):e60576. 1-8. https://doi.org/10.5812/ircmj.60576
  • Irani, H., Sargazi, G.H., Dahmardeh, A.R and Mofrad, Z.P. (2019). The Effect of Oral Care with Miswak Versus Chlorhexidine on the Incidence of Ventilator-Associated Pneumonia: A Clinical Trial Study. Medical Surgical Nursing Journal. 8(4):e100387. 1-7. https://doi.org/10.5812/msnj.100387.
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  • Kariminik A and Motaghi M-M. (2015). Evaluation of Antimicrobial susceptibility pattern of Streptococcus mutans isolated from dental plaques to chlorhexidine, nanosil and common antibiotics. International Journal of Life Sciences, 9(2):18–21. DOI:10.3126/IJLS.V9I2.12040
  • Kaya H, Turan Y, Tunalı Y, Aydın GO, Yuce N, Gurbuz Ş and Tosun K. (2018). Effects of oral care with glutamine in preventing ventilator associated pneumonia in neurosurgical intensive care unit patients. Applied Nursing Research, 33:10-14. https://doi.org/10.1016/j.apnr.2016.10.006
  • Kes, D., Aydin Yildirim, T., Kuru, C., Pazarlıoglu, F., Ciftci, T., and Ozdemir, M. (2021). Effect of 0.12% Chlorhexidine Use for Oral Care on Ventilator-Associated Respiratory Infections: A Randomized Controlled Trial. Journal of trauma nursing: the official journal of the Society of Trauma Nurses, 28(4), 228–234. https://doi.org/10.1097/JTN.0000000000000590
  • Khaky B, Yazdannik A and Mahjobipoor H. (2018). Evaluating the efficacy of nanosil mouthwash on the preventing pulmonary infection in intensive care unit: a randomized clinical trial. Medical Archives, 72(3): 206–209. doi: 10.5455/medarh.2018.72.206-209
  • Klarin B, Adolfsson A, Torstensson A and Larsson A. (2018). Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient? A multicentre, prospective, randomised controlled open trial. Critical Care, 28;22(1):272. doi: 10.1186/s13054-018-2209-4
  • Klarin B, Johansson M-L, Molin G, Larsson A and Jeppsson B. (2005). Adhesion of the probiotic bacterium Lactobacillus plantarum 299v onto the gut mucosa in critically ill patients: a randomised open trial. Critical Care, 9:R285–293. doi: 10.1186/cc3522
  • Klompas M, Li L, Kleinman K, Szumita P.M and Massaro A.F. (2016). Associations between ventilator bundle components and outcomes. JAMA Internal Medicine, 176:1277–1283. https://doi.org/10.1001/jamainternmed.2016.2427
  • Kocaçal Güler E and Türk G. (2018). Oral Chlorhexidine Against Ventilator- Associated Pneumonia and Microbial Colonization in Intensive Care Patients. Western Journal of Nursing Research, 41(6) 1–19. https://doi.org/10.1177/019394591878153
  • Koff MD, Corwin HL, Beach ML, Surgenor SD and Loftus RW. (2011). Reduction in ventilator associated pneumonia in a mixed intensive care unit after initiation of a novel hand hygiene program. Journal of Critical Care, 26 (5), 489-495. https://doi.org/10.1016/j.jcrc.2010.12.013
  • Kshitish D and Laxman VK. (2010). The use of ozonated water and 0.2% chlorhexidine in the treatment of periodontitis patients: a clinical and microbiologic study. Indian Journal of Dental Research. 21(3):341–348. doi: 10.4103/0970-9290.70796
  • Li T, Puhan MA, Vedula SS, Singh S, Dickersin K and for The Ad Hoc Network Meta-analysis Methods Meeting Working Group. (2011). Network meta-analysis-highly attractive but more methodological research is needed. BMC Medicine, 9:79. doi: 10.1186/1741-7015-9-79
  • McCue, M. K., and Palmer, G. A. (2019). Use of Chlorhexidine to Prevent Ventilator-Associated Pneumonia in a Long-term Care Setting: A Retrospective Medical Record Review. Journal of nursing care quality, 34(3), 263–268. https://doi.org/10.1097/NCQ.0000000000000367
  • Meidani M, Khorvash F, Abbasi S, Cheshmavar M and Tavakoli H. (2018). Oropharyngeal irrigation to prevent ventilator-associated-pneumonia: comparing potassium permangenate with chlorhexidine. International Journal of Preventive Medicine, 9:93. 1-4 Doi: 10.4103/ijpvm. IJPVM_370_17
  • Meinberg, M. C., Cheade, M.deF., Miranda, A. L., Fachini, M. M., and Lobo, S. M. (2012). The use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia. Uso de clorexidina 2% gel e escovação mecânica na higiene bucal de pacientes sob ventilação mecânica: efeitos na pneumonia associada a ventilador. Revista Brasileira de terapia intensiva, 24(4), 369–374. https://doi.org/10.1590/s0103-507x2012000400013
  • Nobahar M, Razavi MR, Malek F and Ghorbani R. (2016). Effects of hydrogen peroxide mouthwash on preventing ventilator-associated pneumonia in patients admitted to the intensive care unit. Brazilian Journal of Infectious Diseases, 20(5), 444–450. https://doi.org/10.1016/j.bjid.2016.06.005
  • Özdemir, S and Türk, G. (2022). The effect of different concentrations of chlorhexidine on microbial colonization: A double-blinded randomized controlled study. International Journal of Nursing Practice, 28(2):e13025. 1-9. https://doi.org/10.1111/ijn.13025
  • Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., Stewart L. A., Thomas J, Tricco AC, Welch VA, Whiting P, and Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372, n71. 1-9. https://doi.org/10.1136/bmj.n71
  • Palloş A. (2018). Ağız Bakımının Bakteri Kolonizasyonu ve Ventilatör İlişkili Pnömoni Gelişimini Önlemede Etkisi (Doktora Tezi). İstanbul: İstanbul Üniversitesi-Cerrahpaşa Lisansüstü Eğitim Enstitüsü. 1-128
  • Panchabhai TS, Dangayach NS, Krishnan A, Kothari VM and Karnad DR. (2009). Oropharyngeal cleansing with 0.2% chlorhexidine for prevention of nosocomial pneumonia in critically ill patients: an open-label randomized trial with 0.01% potassium permanganate as control. Chest Journal, 135(5):1150-1156 https://doi.org/10.1378/chest.08-1321
  • Parreco J, Soe-Lin H, Byerly S, Lu N, Ruiz G, Yeh D.D and Rattan N.N. (2020). Multi-center outcomes of chlorhexidine oral decontamination in intensive care units. Surgical Infections, 21(8): 659-664. https://doi.org/10.1089/sur.2019.172
  • Pozuelo-Carrascosa, D. P., Herráiz-Adillo, Á., Alvarez-Bueno, C., Añón, J. M., Martínez Vizcaíno, V., and Cavero-Redondo, I. (2020). Subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of systematic reviews and an updated meta-analysis. European Respiratory Review, 29(155):190107. doi: 10.1183/16000617.0107-2019
  • Pribadi E.S., Rihansyah H.P and Darusman H.S. (2014). In vitro growth inhibition of Candida albicans caused by antifungal properties of miswak (Salvadora persica Linn.) ethanolic extract and commercial mouthwash. Oral Health and Dental Management, 13(4):1048–1051.
  • Rouse B, Chaimani A and Li T. (2017). Network meta-analysis: An introduction for clinicians. Internal and Emergency Medicine, 12(1): 103–111. doi: 10.1007/s11739-016-1583-7
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  • Tufanaru, C., Munn, Z., Aromataris, E., Campbell, J., and Hopp, L. (2020). Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis.pp.72-133 https://doi.org/10.46658/JBIMES-20-04
  • Tuon, F. F., Gavrilko, O., de Almeida, S., Sumi, E. R., Alberto, T., Rocha, J. L and Rosa, E. A. (2017). Prospective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine. Journal of Global Antimicrobial Resistance, 8, 159-163. https://doi.org/10.1016/j.jgar.2016.12.007
  • Varma S.R., Sherif H., Serafi A., Fanas S.A., Desai V., Abuhijleh E and Al Radaidah A. (2018). The antiplaque efficacy of two herbal-based toothpastes: A clinical intervention. Journal of International Society of Preventive Community Dentistry, 8(1):21–27. doi: 10.4103/jispcd. JISPCD_411_17
  • Ward E, Smith M, Henderson M, Reid U, Lewis I, Kinsey S, Allgar V, Bowers D and Picton SV. (2009). The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients. European Journal of Clinical Nutrition, 63(1):134–140 doi: 10.1038/sj.ejcn.1602894
  • Zand F, Zahed L, Mansouri P, Dehghanrad F, Bahrani M and Ghorban M. (2017). The effects of oral rinse with 0.2% and 2% chlorhexidine on oropharyngeal colonization and ventilator associated pneumonia in adults’ intensive care units. Journal of Critical Care, 40,318-22. https://doi.org/10.1016/j.jcrc.2017.02.029
Toplam 56 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Makaleler
Yazarlar

Sercan Özdemir 0000-0001-6783-2045

Gülengün Türk 0000-0001-8649-0204

Zekiye Karaçam 0000-0002-0419-8961

Erken Görünüm Tarihi 16 Eylül 2024
Yayımlanma Tarihi 30 Eylül 2024
Gönderilme Tarihi 8 Nisan 2024
Kabul Tarihi 2 Temmuz 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 7 Sayı: 2

Kaynak Göster

APA Özdemir, S., Türk, G., & Karaçam, Z. (2024). Effectiveness of oral care solutions to prevent VAP in patients on mechanical ventilation: Systematic review and meta-analysis. Izmir Democracy University Health Sciences Journal, 7(2), 172-190. https://doi.org/10.52538/iduhes.1466964

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