Effect of nebulized eucalyptus on contamination of microbial plaque of endotracheal tube in ventilated patients.
BACKGROUND
Formation of biofilm and bacterial colonization within the endotracheal tube (ETT) are significant sources of airway contamination and play a role in the development of ventilator-associated pneumonia (VAP). This study was conducted to examine the effect of nebulized eucalyptus (NE) on bacterial colonization of ETT biofilm.


METHODS
We performed a randomized clinical trial in three intensive care units (ICUs) of an educational hospital. Seventy intubated patients were selected and randomly divided into intervention (n = 35) and control (n = 35) groups. The intervention group received 4 ml (5%) of eucalyptus in 6 ml normal saline every 8 h. The placebo group received only 10 ml of normal saline in the same way. On extubation, the interior of the tube was immediately sampled using a sterile swab for standard microbiological analysis. Chi-square and Fisher's exact tests were used for statistical analysis in SPSS. P values less than 0.05 were considered statistically significant.


RESULTS
In both samples, Klebsiella pneumoniae and Acinetobacter baumannii were the most frequently isolated bacteria. In the control group, heavy colonization was greater than in the intervention group (P = 0.002). The frequency of isolation of K. pneumoniae in the intervention group was lower than in the control group (P < 0.001). However, there was no difference between the two groups in other isolated bacteria.


CONCLUSIONS
NE can reduce microbial contamination of the endotracheal tube biofilm in ventilated patients. Moreover, K. pneumoniae was the most sensitive to NE.
Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
Nazanin
N
Amini
Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
Korosh
K
Rezaei
Ulcer Repair Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Ahmadreza
A
Yazdannik
Biofilms; Iran; endotracheal intubation; endotracheal tube; eucalyptus; nebulizers