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Prevention of ventilator associated pneumonia - evidence in oral care

2018-09-13Documento de conferência Acesso aberto
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dc.contributor.authorSousa, Ana
dc.contributor.authorFerrito, Cândida
dc.date.accessioned2021-08-02T09:43:19Z
dc.date.available2021-08-02T09:43:19Z
dc.date.issued2018-09-13
dc.description.abstractBackground: Ventilator-associated pneumonia (VAP) is the most important noso- comial infection in intensive care units (ICUs), with an estimated inci- dence rate of 50% and the major cause of mortality and morbidity in ICUs [1,2]. Inadequate oral care develops an important role in this setting allowing various organisms to flourish in oral cavity and cause infections [1]. Many VAP prevention guidelines include oral care, but they don’t specify its demandings. Objective: The aim of this study is to describe evidence-based VAP prevention oral care in ICU, in terms of products, frequency and technique. Methods Integrative review. Research was conducted on B-on, PUBMED, and RCAAP between 24 and 28 December 2015, including guide- lines and original articles from the last 5 years. We found 256 documents and after analysing their abstract and methodological quality, nine documents were selected. Data were compiled in a chart in terms of grade of evidence, acceptance and applicability. Results: We found inconsistent results regarding the use of an antiseptic solution in oral care, though there were meta-analysis which indi- cated the benefit of chlorhexidine mostly in cardio-thoracic surgi- cal patients [2-4]. We also found evidence that tooth brushing reduces oral bacterial colonization and may reduce VAP when used with chlorhexidine [5,6]. There is no consensus regarding the adequate concentration of chlorhexidine. Some studies, thought, find an association with the use of chlorhexidine 2% and the incidence of Acute Respiratory Distress Syndrome [7]. Because of this potential risk, we do not recommend the use of this type of concentration, as more randomized controlled trials are needed. We found evidence in VAP prevention oral care compris- ing suctioning, tooth and gums wash and rising with 15 mL chlorhexidine 0.12%. This procedure should be performed at least 2 times a day. Secretions removal and moisturization should occur between 2 to 4 times a day [1-9]. Conclusions: This review allowed us to describe the adequate oral care in ICUs in order to potentially reduce VAP. As limitation of this study, we can find the lack of high grade of evidence concerning most recommen- dations. More randomized controlled trials are needed to support the impact of each intervention separately.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.urihttp://hdl.handle.net/10400.14/34351
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectICUpt_PT
dc.subjectOral carept_PT
dc.subjectChlorhexidinept_PT
dc.subjectTooth brushingpt_PT
dc.subjectVentilator-associated pneumoniapt_PT
dc.titlePrevention of ventilator associated pneumonia - evidence in oral carept_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.conferencePlaceLeiriapt_PT
oaire.citation.endPage160pt_PT
oaire.citation.startPage159pt_PT
oaire.citation.title4th IPLeiria’s International Health Congresspt_PT
person.familyNameFerrito
person.givenNameCândida
person.identifier.ciencia-idE81B-8BF4-68ED
person.identifier.orcid0000-0002-2834-8573
person.identifier.scopus-author-id57195483256
rcaap.rightsopenAccesspt_PT
rcaap.typeconferenceObjectpt_PT
relation.isAuthorOfPublication635d05bd-d33a-46fd-aa9f-6ae86cfe6473
relation.isAuthorOfPublication.latestForDiscovery635d05bd-d33a-46fd-aa9f-6ae86cfe6473

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