- 期刊
Effectiveness of an Oral Care Protocol for Preventing Ventilator-Associated Pneumonia
重症呼吸器病人口腔護理標準對呼吸器關聯性肺炎的預防成效
摘要
This study attempted to establish an oral care protocol (OCP) with 1% chlorhexidine gluconate for mechanical-ventilated critically ill patients, and to test its effectiveness in improving oral hygiene, reducing colonization of the oral cavity, and ventilator-associated pneumonia. Method: Using a double-blind, randomized, experimental study design; 202 critically ill mechanical-ventilated patients from the intensive care unit of a medical center were enrolled in this study. One hundred and forty one patients met the retention criteria and remained in the study. The control group (n=74) received routine oral care, while the experimental group (n=67) received OCP care daily. The research tools included dental plaque assessment, indicators of ventilator-associated pneumonia and microbiological analysis of oral and tracheal secretions. Basic information was collected from both groups within 24 hours after intubation, and then on days 6 and 14 following the oral care interventions. Results: The experimental group receiving OCP had better oral hygiene (p=＜.001) and less colonization of oral and tracheal secretion (p=＜.001). Meanwhile, the control group had higher rates of VAP infection (odds ratio: 5.01, 95% C.I.=1.43-19.65), significantly longer period of ventilator dependence (16.56 days vs. 11.16 days, p=.01) and length of stay in ICU than the experimental group (18.02 days vs. 13.07 days, p=.02). However, there was no significant difference between two groups in extubation rates. Conclusions: This study designed a standardized OCP for critically ill patients that has proved its effectiveness in improving oral hygiene and reducing VAP rate.
並列摘要
This study attempted to establish an oral care protocol (OCP) with 1% chlorhexidine gluconate for mechanical-ventilated critically ill patients, and to test its effectiveness in improving oral hygiene, reducing colonization of the oral cavity, and ventilator-associated pneumonia. Method: Using a double-blind, randomized, experimental study design; 202 critically ill mechanical-ventilated patients from the intensive care unit of a medical center were enrolled in this study. One hundred and forty one patients met the retention criteria and remained in the study. The control group (n=74) received routine oral care, while the experimental group (n=67) received OCP care daily. The research tools included dental plaque assessment, indicators of ventilator-associated pneumonia and microbiological analysis of oral and tracheal secretions. Basic information was collected from both groups within 24 hours after intubation, and then on days 6 and 14 following the oral care interventions. Results: The experimental group receiving OCP had better oral hygiene (p=＜.001) and less colonization of oral and tracheal secretion (p=＜.001). Meanwhile, the control group had higher rates of VAP infection (odds ratio: 5.01, 95% C.I.=1.43-19.65), significantly longer period of ventilator dependence (16.56 days vs. 11.16 days, p=.01) and length of stay in ICU than the experimental group (18.02 days vs. 13.07 days, p=.02). However, there was no significant difference between two groups in extubation rates. Conclusions: This study designed a standardized OCP for critically ill patients that has proved its effectiveness in improving oral hygiene and reducing VAP rate.
參考文獻
延伸閱讀
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