Fatores associados à higiene oral do paciente crítico com COVID-19

Abstract

Objetivo: O presente estudo teve como objetivo avaliar a higiene oral do paciente crítico com COVID-19 e fatores associados. Métodos: foi realizado um estudo transversal, que consta na avaliação da higiene oral de pacientes internados em UTI com COVID-19 sob uso de ventilação mecânica por meio do Índice de Higiene Oral Simplificado (IHO-S) e do Indicador de Higiene Oral do Paciente Crítico (IHOPC). Resultados: a amostra foi composta por 139 pacientes, sendo 59% do sexo masculino, 44,6% obesos, 93,5% com tubo orotraqueal e 69,8% com alguma comorbidade, dos quais 33,8% apresentaram-se com IHO-S classificado como regular e 12,9% como ruim; e 51,8% com IHOPC precária. Apresentaram avaliação da higiene oral precária por meio do IHOPC os pacientes com maior idade (p=0,049), maior tempo de internação (p=0,018) e com maior tempo de ventilação mecânica (p=0,031). Conclusão: a realização da higiene oral do paciente crítico com COVID-19 necessita ser intensificada nos pacientes internados em UTIs sobretudo os que permanecem longos períodos internados e em ventilação mecânica como forma de evitar intercorrências maiores com paciente já em estados graves.

Analysis of patients hospitalized by Covid-19 regarding oral care during hospitalization

“…The respondent was asked about the place of hospitalization, 14 of the 20 individuals were hospitalized in the public health network and 6 in the private network. Moreover, the hospitalization time of 40% of the individuals was less than 10 days, which concurs with Conceição's study, in which the time was around 6 days 8 .…”

“…In this research, 50% of the interviewees reported needing ICU care. To assist in their survival, mechanisms such as orotracheal intubation and the use of invasive mechanical ventilation are used, which causes poor oral hygiene, increasing the risk of complications in the systemic health of the individual, such as ventilator-associated pneumonia 8 .…”

“…The interviewees scored, after the hospitalization period, the presence of dental calculus (60%), halitosis (40%), caries (40%) and lesions on the mucosa (40%). The precariousness in the oral hygiene of hospitalized patients makes the oral cavity susceptible to pathogenic microorganisms, especially in individuals who require mechanical ventilation, because they are sedated, with decreased motor activity and mouth opening for a long period, which causes dehydration of the oral mucosa, decreased salivary flow and decreased cough reflex, predisposing the cavity to ulcers, site of bacteria that cause dental biofilm and caries 8 . In the pandemic situation that the world has witnessed, the role of the dental surgeon has become even more notorious, since hospitalizations for long periods of time increase the risk of oral lesions and infections.…”