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ORIGINAL ARTICLE
Year : 2022  |  Volume : 27  |  Issue : 2  |  Page : 99-105

Comparative study of the effect of three oral care protocols on ventilator-associated pneumonia in critically ill patients: A clinical trial


1 MSc in Critical Care Nursing, Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor of Critical Care Medicine, Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Critical Care Nursing, Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Samira Ghasemi Gavarti
MSc in Critical Care Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnmr.IJNMR_243_20

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Background: Oral care plays a significant role in reducing the incidence of Ventilator-Associated Pneumonia (VAP) in Intensive Care Units (ICUs). The aim of this study was to investigate the effect of three oral care protocols on the incidence of VAP in Mechanically-Ventilated (MV) patients hospitalized in ICUs. Materials and Methods: This parallel randomized clinical trial was performed in 2019 on 71 MV adult patients with endotracheal intubation hospitalized in ICUs. The patients were divided into three groups: a 7-day oral care by using swab (group 1), two-times-brushing group (group 2), and four-times-brushing group (group 3) by using chlorhexidine. The data related to the incidence of pneumonia were analyzed during several days using Chi-square and ANOVA tests. Results: The incidence of pneumonia on the fourth day of the intervention in the first group (35.00%) was significantly higher than that of the two intervention groups (10.00%) (χ2 = 5.86, df = 2, p = 0.03)). The mean score of modified clinical pulmonary infection in the third group was significantly lower seven days after the intervention than before the intervention (p = 0.04) and the fourth day of intervention (p = 0.003). In the first group, this score was significantly higher in the fourth day of the intervention than the seventh day (p = 0.003). Conclusions: Based on the results, the oral care protocol, including four-times-brushing, reduced the risk of VAP more than two times brushing. Therefore, the use of this protocol is recommended to provide a minimum level of oral care and reduce the risk of VAP in MV patients.


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