title: Effect of oral hygiene with 0.12% chlorhexidine gluconate on the incidence of nosocomial pneumonia in children undergoing cardiac surgery.
abstract: OBJECTIVE
  To evaluate the effect of oral hygiene with 0.12% chlorhexidine gluconate on the incidence of nosocomial pneumonia and ventilator-associated pneumonia (VAP) in children undergoing cardiac surgery.
  
  
  METHODS
  Prospective, randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Pediatric intensive care unit (PICU) at a tertiary care hospital.
  
  
  METHODS
  One hundred sixty children undergoing surgery for congenital heart disease, randomized into 2 groups: chlorhexidine (n = 87) and control (n = 73).
  
  
  METHODS
  Oral hygiene with 0.12% chlorhexidine gluconate or placebo preoperatively and twice a day postoperatively until PICU discharge or death.
  
  
  RESULTS
  Patients in experimental and control groups had similar ages (median, 12.2 vs 10.8 months; P = .72) and risk adjustment for congenital heart surgery 1 score distribution (66% in category 1 or 2 in both groups; P = .17). The incidence of nosocomial pneumonia was 29.8% versus 24.6% (P = .46) and the incidence of VAP was 18.3% versus 15% (P = .57) in the chlorhexidine and the control group, respectively. There was no difference in intubation time (P = .34), need for reintubation (P = .37), time interval between hospitalization and nosocomial pneumonia diagnosis (P = .63), time interval between surgery and nosocomial pneumonia diagnosis (P = .10), and time on antibiotics (P = .77) and vasoactive drugs (P = .16) between groups. Median length of PICU stay (3 vs 4 days; P = .53), median length of hospital stay (12 vs 11 days; P = .67), and 28-day mortality (5.7% vs 6.8%; P = .77) were also similar in the chlorhexidine and the control group.
  
  
  CONCLUSIONS
  Oral hygiene with 0.12% chlorhexidine gluconate did not reduce the incidence of nosocomial pneumonia and VAP in children undergoing cardiac surgery.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT00829842 .
authors.affiliation: Department of Pediatrics, Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Andréa D N
authors.initials: AD
authors.lastname: Jácomo
authors.forename: Fabio
authors.initials: F
authors.lastname: Carmona
authors.forename: Alessandra K
authors.initials: AK
authors.lastname: Matsuno
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Manso
authors.forename: Ana P C P
authors.initials: AP
authors.lastname: Carlotti
mesh_terms: D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D009067:Mouthwashes / Q000627:therapeutic use*; D009910:Oral Hygiene / Q000379:methods*; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012121:Respiration, Artificial / Q000009:adverse effects; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D009067:Mouthwashes; C010882:chlorhexidine gluconate; D002710:Chlorhexidine