Evaluating the Efficacy of Nanosil Mouthwash on the Preventing Pulmonary Infection in Intensive Care Unit: a Randomized Clinical Trial

Abstract

Introduction:Oral and Oro-pharynx colonization and Micro-aspiration of discharges are two important processes in ventilator-associated pneumonia (VAP). So, this study design to investigated the preventive effect of oral decontamination program by Nanosil mouthwash on incidence of ventilator-associated pneumonia.Methods:80 newly hospitalized patients who admitted in intensive care unit (ICU) of Amin Medical Education Center were enrolled to a randomized clinical trial study. Patients were randomly divided into two equal groups. In the intervention group, a multi-stage oral decontamination program was performed by using Nanosil mouthwash three times a day, and in the control group oral decontamination was performed by Chlorhexidine 0.12% with same method. The oral decontamination program was continuing for five days. The VAP was diagnosed with a version of modified clinical pulmonary infection scale (MCPIS) on the first and fifth days.Results:In compare the case and control groups, there wasn’t observed significant difference in age, gender, underling disease, smoking, and primary mean scores of MCPIS, sequential organ failure assessment (SOFA) and Glasgow coma scale (GCS) (P>0.05). In the both groups, the mean scores of SOFA and GCS were significantly improve in fifth day (P<0.05). After five days follow up, the mean score of MCPIS (1.2±0.1 vs. 3.5±0.3, P<0.001) and pneumonia rate (2.7% vs. 23.7%, P=0.008) were significantly lower in case group. But, the mortality rate was same in both groups (P>0.05).Discussion:The use of oral care program with Nanosil mouthwash is better than Chlorhexidine for the prevention of VAP in patients who admitted in ICU.

Risk factors for oral alterations in intensive care unit patients: A pilot cohort study

“…Male patients had 2 times the risk of having alterations throughout the hospital stay compared to the patients of female gender. This can be related to better oral hygiene practices before hospitalization and increased utilization of oral health care services among women 2,5 …”

“…Some patients present oral alterations at the time of ICU admission, which might be related to a poor oral hygiene 2,5 . During hospitalization, the oral health of ICU patients is at risk due to the general medical condition of the patient and the complex treatments applied.…”

Measures used in intensive care units to prevent infection: an integrative review

“…Outra pesquisa de ensaio clínico randomizado avaliou a eficácia de um enxaguatório bucal de Nanosil para prevenção da pneumonia associada à ventilação. Quando comparado com a clorexidina a 2%, o Nanosil revelou efeito antibacteriano de amplo espectro e mais forte sobre as bactérias orais (16) . Entretanto, quando comparada com o permanganato de potássio, a clorexidina se mostrou mais eficaz (17) .…”

The Role of Dysbiosis in Critically Ill Patients With COVID-19 and Acute Respiratory Distress Syndrome

“…The use of mouthwashes to prevent pneumonia is still debated. A randomized controlled trial (RCT) on 80 ICU patients who were randomized to receive Nanosil mouthwashes and chlorhexidine 0.12% for 5 days demonstrated that the pneumonia rate was reduced in the Nanosil group (2.7 vs. 23.7%, p = 0.008), but mortality was similar in both groups (88). Another trial investigating the role of peroxide hydrogen over normal saline in the prevention of pneumonia concluded that patients treated with peroxide hydrogen had a lower risk of contracting VAP (relative risk [RR], 2.6; 95% confidence interval [CI], 1.04-6.49, p = 0.0279) (89).…”