Oral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: Randomised, controlled and double blind trial

Oral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: Randomised, controlled and double blind trial

Author Kusahara, Denise Miyuki Autor UNIFESP Google Scholar
Sorgini Peterlini, Maria Angelica Autor UNIFESP Google Scholar
Goncalves Pedreira, Mavilde Luz Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: To test the effectiveness of oral care with 0.12% chlorhexidine in decreasing ventilator-associated pneumonia in critically ill children.Methods: Prospective, randomised, controlled, double-blind clinical trial performed in a paediatric critical care unit at a university hospital. the sample was composed of 96 mechanically ventilated children randomly allocated to the chlorhexidine group (oral care with a toothbrush and an antiseptic gel twice a day) and the placebo group (oral care with a toothbrush and a non-antiseptic gel twice a day). Microbiological analyses of oropharyngeal and tracheal secretions were performed 24, 48 and 96 h after intubation. Chi-square, Fischer's exact and Mann-Whitney tests were applied (p <= 0.05).Results: the chlorhexidine group was composed of 46 children, and the placebo group consisted of 50 children. Within these samples, 15 (32.6%) children in the chlorhexidine group and 16 (32.0%) children in the placebo group developed ventilator-associated pneumonia (p = 0.949). Children in the chlorhexidine group without potentially pathogenic microflora in their oropharynx 24 h after mechanical ventilation presented with fewer episodes of ventilator-associated pneumonia (p = 0.019). the pathogen colonization profile of children with ventilator-associated pneumonia in the chlorhexidine group included Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. in the placebo group, Pseudomonas aeruginosa and Escherichia coli were the predominant potentially pathogenic microorganisms. the intervention did not influence paediatric intensive care unit mortality (p = 0.425), hospital length of stay (p = 0.143), or paediatric intensive care unit length of stay (p = 0.177).Conclusions: the use of 0.12% chlorhexidine did not significantly modify the VAP incidence in a sample of mechanically ventilated children. (C) 2012 Elsevier B.V. All rights reserved.
Keywords Ventilator-associated pneumonia
Oral hygiene
Chlorhexidine
Critical care
Paediatric nursing
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 04-13361-2
Date 2012-11-01
Published in International Journal of Nursing Studies. Oxford: Pergamon-Elsevier B.V., v. 49, n. 11, p. 1354-1363, 2012.
ISSN 0020-7489 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 1354-1363
Origin http://dx.doi.org/10.1016/j.ijnurstu.2012.06.005
Access rights Closed access
Type Article
Web of Science ID WOS:000311770300004
URI http://repositorio.unifesp.br/handle/11600/35470

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