The effects of oral rinse with 0.2% and 2% chlorhexidine on oropharyngeal colonization and ventilator associated pneumonia in adults' intensive care units.
Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of oropharyngeal colonization and VAP.



This study was performed on 114 patients from trauma, surgery, neurosurgery, and general ICUs randomly allocated to two groups under oral care with 0.2% and 2% chlorhexidine solution. A multidisciplinary team approved the oral care protocol. Data was collected using a demographic information form, APACHE IV form, Beck oral assessment scale, mucosal-plaque assessment scale, and oropharyngeal swab culture.



The results showed a significant reduction in VAP (p=0.007) and oropharyngeal colonization (p=0.007) in the group under oral care with 2% chlorhexidine solution compared with the other group. However, no significant difference was found between the two groups in terms of oropharyngeal adverse effects (p=0.361).



Oral decontamination with 2% compared to 0.2% chlorhexidine is a more effective method in the prevention of VAP and reduction of oropharyngeal colonization (especially gram-positive).
Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Farid
F
Zand
Fatemeh Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran.
Leili
L
Zahed
Fatemeh Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: Mansoorip@sums.ac.ir.
Parisa
P
Mansouri
Fatemeh Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran.
Freshte
F
Dehghanrad
Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Maryam
M
Bahrani
Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Mohammad
M
Ghorbani
D018806:APACHE; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage*; D004339:Drug Compounding; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D009067:Mouthwashes / Q000008:administration & dosage*; D009960:Oropharynx / Q000382:microbiology; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D002710:Chlorhexidine
Chlorhexidine; Oral rinse; Oropharyngeal; Ventilator associated pneumonia