ObjectiveTo evaluate the effects of oral chlorhexidine hygiene with toothbrushing on the
rate of ventilator-associated pneumonia in a mixed population of critically ill
patients under prolonged mechanical ventilation. MethodsProspective, randomized, and placebo-controlled pilot study. Patients who were
receiving mechanical ventilation, had been admitted less than 24 hours prior, and
were anticipated to require mechanical ventilation for more than 72 hours were
included in the study. The patients were randomly divided into one of the
following groups: chlorhexidine hygiene with toothbrushing or a placebo group (gel
with the same color and consistency and toothbrushing). ResultsThe planned interim analysis was conducted using 52 patients, and the study was
terminated prematurely. In total, 28 patients were included in the chlorhexidine /
toothbrushing group, and 24 patients were included in the placebo group.
Ventilator-associated pneumonia occurred in 45.8% of the placebo group and in
64.3% of the chlorhexidine hygiene with toothbrushing group (RR=1.4; 95%
CI=0.83-2.34; p=0.29). ConclusionBecause the study was terminated due to futility, it was not possible to evaluate
the impact of oral hygiene using 2% chlorhexidine and toothbrushing on the
incidence of ventilator-associated pneumonia in this heterogeneous population of
critical patients receiving long-term mechanical ventilation, and no beneficial
effect was observed for this intervention.
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