Effect of oral hygiene and 0.12% chlorhexidine gluconate oral rinse in preventing ventilator-associated pneumonia after cardiovascular surgery

Respiratory Care

Volumn 59, Issue 4, 2014, Pages 504-509

  Nicolosi, Liliana Noemí ^a,b   del Carmen Rubio, Maria ^a,b   Martinez, Carlos Daniel ^a,b   González, Nidia Noemí ^a   Cruz, Marisa Edith ^a  

^a UNIVERSIDAD DE BUENOS AIRES   (Argentina)

^b HOSPITAL ESPAÑOL   (Argentina)

Author keywords

Cardiovascular surgery; Chlorhexidine; Prevention; Ventilator associated pneumonia

Indexed keywords

CHLORHEXIDINE GLUCONATE; MOUTHWASH; CHLORHEXIDINE; TOPICAL ANTIINFECTIVE AGENT;

ADULT; ARTICLE; CARDIOVASCULAR SURGERY; COMPUTER ASSISTED TOMOGRAPHY; CONTROLLED STUDY; EXTUBATION; FEMALE; HOSPITAL INFECTION; HUMAN; INCIDENCE; INTUBATION; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; META ANALYSIS (TOPIC); MOUTH HYGIENE; QUASI EXPERIMENTAL STUDY; RANDOMIZED CONTROLLED TRIAL (TOPIC); TOOTH BRUSHING; TOOTH PLAQUE; VENTILATOR ASSOCIATED PNEUMONIA; ANALOGS AND DERIVATIVES; EPIDEMIOLOGY; MIDDLE AGED; PNEUMONIA, VENTILATOR-ASSOCIATED; POSTOPERATIVE COMPLICATIONS; STATISTICS AND NUMERICAL DATA;

ANTI-INFECTIVE AGENTS, LOCAL; CARDIOVASCULAR SURGICAL PROCEDURES; CHLORHEXIDINE; FEMALE; HISTORICALLY CONTROLLED STUDY; HUMANS; INCIDENCE; LENGTH OF STAY; MALE; MIDDLE AGED; MOUTHWASHES; PNEUMONIA, VENTILATOR-ASSOCIATED; POSTOPERATIVE COMPLICATIONS; TOOTHBRUSHING;

EID: 84898725679     PISSN: 00201324     EISSN: 19433654     Source Type: Journal    
DOI: 10.4187/respcare.02666     Document Type: Article

References (52)

1. Rello J, Ollendorf DA, Oster G. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 2002; 122(6):2115-2121.
2. Arabi Y, Al-Shirawi N, Memish Z. Ventilator-associated pneumonia in adults in developing countries: a systematic review. Int J Infect Dis 2008;12(6):505-512.
3. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004;32(8):470-485.
4. Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002;165(7):867-903.
5. Hortal J, Giannella M, Pérez MJ, Barrio JM, Desco M, Bouza E, Muñoz P. Incidence and risk factors for ventilator-associated pneumonia after major heart surgery. Intensive Care Med 2009;35(9):1518-1525.
6. De Jonge E, Schultz MJ, Spanjaard L, Bossuyt PM, Vroom MB, Dankert J, Kesecioglu J. Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet 2003;362(9389):1011-1016.
7. Bergmans DC, Bonten MJ, Gaillard CA, Paling JC, van der Geest S, van Tiel FH, et al. Prevention of ventilator-associated pneumonia by oral decontamination: a prospective, randomized, double-blind, placebo- controlled Study. Am J Respir Crit Care Med 2001;164(3):382-388.
8. Seguin P, Tanguy M, Laviolle B, Tirel O, Mallédant Y. Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma. Crit Care Med 2006; 34(5):1514-1519.
9. Denton GW. Chlorhexidine. In: Block SS, editor. Disinfection, sterilization, and preservation. 5th edition. Philadelphia: Lippincott Williams & Wilkins; 2001:321-326.
10. Hunter JD. Ventilator associated pneumonia. BMJ 2012;344:e3325.
11. Zandstra DF, Petros AJ, Silvestri L, van Saene HKF, Taylor N. Critical illness related pneumonia rather than ventilator-associated pneumonia (VAP) Respir Care 2012;57(2):329-330.
12. D'Amico R, Pifferi S, Leonetti C, Torri V, Tinazzi A, Liberati A. Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 1998;316(7140): 1275-1285.
13. Falagas ME, Siempos II, Bliziotis IA, Michalopoulos A. Administration of antibiotics via respiratory tract for the prevention of ICU-acquired pneumonia: a meta-analysis of comparative trials. Crit Care 2006;10(4): R123.
14. Konvalinka A, Errett L, Fong IW. Impact of treating Staphylococcus aureus nasal carriers on wound infections in cardiac surgery. J Hosp Infect 2006;64(2):162-168.
15. Mori N, Hitomi S, Nakajima J, Okuzumi K, Murakami A, Kimura S. Unselective use of intranasal mupirocin ointment for controlling propagation of methicillin-resistant Staphylococcus aureus in a thoracic surgery ward. J Infect Chemother 2005;11(5):231-233.
16. Trautmann M, Stecher J, Hemmer W, Luz K, Panknin HT. Intranasal mupirocin prophylaxis in elective surgery. A review of published studies. Chemotherapy 2008;54(1):9-16.
17. Walsh EE, Greene L, R Kirshner. Sustained reduction in methicillin- resistant Staphylococcus aureus wound infections after cardiothoracic surgery. Arch Intern Med 2011;171(1):68-73.
18. Inkster T. Antibiotic prophylaxis for cardiac surgery: a shift away from traditional cephalosporins? J Cardiothorac Vasc Anesth 2009;23(6):933-935.
19. National Institute for Health and Clinical Excellence. Surgical site infection (CG74). London: National Institute for Health and Clinical Excellence, October 2008. http://www.nice.org.uk/guidance/cg74
20. Bhatti F, Grayson AD, Grotte G, Fabri BM, Au J, Jones M, et al. The logistic EuroSCORE in cardiac surgery: how well does it predict operative risk? Heart 2006;92(12):1817-1820.
21. Karthik S, Srinivasan AK, Grayson AD, Jackson M, Sharpe DA, Keenan DJ, et al. Limitations of additive EuroSCORE for measuring risk stratified mortality in combined coronary and valve surgery. Eur J Cardiothorac Surg 2004;26(2):318-322.
22. Bass CC. An effective method of personal hygiene. J La State Med Soc 1954;106(3):100-112.
23. Imai PH, Yu X, MacDonald D. Comparison of interdental brush to dental floss for reduction of clinical parameters of periodontal disease: a systematic review. Can J Dent Hyg 2012;46(1):63-78.
24. Rajapakse PS, McCracken GI, Gwynnett E, Steen ND, Guentsch A, Heasman PA. Does tooth brushing influence the development and progression of non- inflammatory gingival recession: a systematic review. J Clin Periodontol 2007;34(12):1046-1061.
25. Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 11th edition. St. Louis: Elsevier/Saunders; 2011:422-426.
26. Rotstein C, Evans G, Born A, Grossman R, Light RB, Magder S, et al. Clinical practice guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia in adults. Can J Infect Dis Med Microbiol 2008;19(1):19-53.
27. American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005;171(4):388-416.
28. Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med 2005;33(10):2184-2193.
29. Coffin SE, Klompas M, Classen D, Arias KM, Podgorny K, Anderson DJ, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(1 Suppl):S31-S40.
30. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in combined medical surgical intensive care units in the United States. Infect Control Hosp Epidemiol 2000;21(8):510-515.
31. Ibrahim EH, Tracy L, Hill C, Fraser VJ, Kollef MH. The occurrence of ventilator-associated pneumonia in a community hospital: risk factors and clinical outcomes. Chest 2001;120(2):555-561.
32. Estes RJ, Meduri GU. The pathogenesis of ventilator-associated pneumonia: mechanisms of bacterial transcolonisation and airway inoculation. Intensive Care Med 1995;21(4):365-383.
33. Bagg J, Mac Farlane TW, Poxton IR, Miller CH, Smith AJ. Essentials of microbiology for dental students. 3rd edition. New York: Oxford University Press; 1999:227-310.
34. Gibbons RJ. Bacterial adhesion to oral tissues: a model for infectious diseases. J Dent Res 1989;68(5):750-760.
35. Berry AM, Davidson PM, Masters J, Rolls K. Systematic literature review of oral hygiene practices for intensive care patients receiving mechanical ventilation. Am J Crit Care 2007;16(6):552-562.
36. Chan EY, Ruest A, Meade MO, Cook DJ. Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis. BMJ 2007;334(7599):889.
37. O'Reilly M. Oral care of the critically ill: a review of the literature and guidelines for practice. Crit Care 2003;16(3):101-110.
38. Kola A, Gastmeier P. Efficacy of oral chlorhexidine in preventing lower respiratory tract infections. Meta-analysis of randomized controlled trials. J Hosp Infect 2007;66(3):207-216.
39. Pileggi C, Bianco A, Flotta D, Nobile CG, Pavia M. Prevention of ventilator-associated pneumonia, mortality and all intensive care unit acquired infections by topically applied antimicrobial or antiseptic agents: a meta-analysis of randomized controlled trials in intensive care units. Crit Care 2011;15(3):R155.
40. Panchabhai TS, Dangayach NS, Krishnan A, Kothari VM, Karnad DR. Oropharyngeal cleansing with 0.2% chlorhexidine for prevention of nosocomial pneumonia in critically ill patients: an open-label randomized trial with 0.01% potassium permanganate as control. Chest 2009;135(5):1150-1156.
41. Munro CL, Grap MJ, Jones DJ, McClish DK, Sessler CN. Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. Am J Crit Care 2009;18(5):428-437.
42. Segers P, Speekenbrink RG, Ubbink DT, van Ogtrop ML, de Mol BA. Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial. JAMA 2006;296(20):2460-2466.
43. Tantipong H, Morkjareonpong C, Jaiyindee S, Thamlikitkul V. Randomized controlled trial and meta-analysis of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia. Infect Control Hosp Epidemiol 2008;29(2):131-136.
44. Pineda LA, Saliba RG, El Solh AA. Effect of oral decontamination with chlorhexidine on the incidence of nosocomial pneumonia: a meta-analysis. Crit Care 2006;10(1):R35.
45. Bellissimo-Rodrigues F, Bellissimo-Rodrigues WT, Viana JM, Teixeira GC, Nicolini E, Auxiliadora-Martins M, et al. Effectiveness of oral rinse with chlorhexidine in preventing nosocomial respiratory tract infections among intensive care unit patients. Infect Control Hosp Epidemiol 2009;30(10):952-958.
46. Koeman M, van der Ven AJAM, Hak E, Joore, HCA, Kaasjager K, de Smet AGA, et al. Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia. Am J Respir Crit Care Med 2006;173(12):1348-1355.
47. Chlebicki MP, Safdar N. Topical chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. Crit Care Med 2007;35(2):595-602.
48. Zamora Zamora F. Effectiveness of oral care in the prevention of ventilator-associated pneumonia. Systematic review and meta-analysis of randomised clinical trials. Enferm Clin 2011;21(6):308-319.
49. de Smet AM, Kluytmans JA, Cooper BS, Mascini EM, Benus RF, van der Werf TS, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 2009;360(1):20-31.
50. Lador A, Nasir H, Mansur N, Sharoni E, Biderman P, Leibovici L, Paul M. Antibiotic prophylaxis in cardiac surgery: systematic review and meta-analysis. J Antimicrob Chemother 2012;67(3):541-50.
51. DeRiso AJ 2nd, Ladowski JS, Dillon TA, Justice JW, Peterson AC. Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and non-prophylactic systemic antibiotic use in patients undergoing heart surgery. Chest 1996;109(6):1556-1561.
52. Houston S, Hougland P, Anderson JJ, LaRocco M, Kennedy V, Gentry LO. Effectiveness of 0.12% chlorhexidine oral rinse in reducing prevalence of nosocomial pneumonia in patients undergoing heart surgery. Am J Crit Care 2002;11(6):567-570.