Prevention of aspiration pneumonia (AP) with oral care

Tada, Akio; Miura, Hiroko

doi:10.1016/j.archger.2011.06.029

Cited by 79 publications

(59 citation statements)

References 65 publications

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“…Previous research recommended having a study with a longer duration and higher number of patients, to possibly support the theory that effective oral care is an important contributing factor in the prevention of aspiration pneumonia. (7,21) Patients in both the chlorhexidine and control groups did not show any significant differences (p = 0.165) in adverse effects or improvements to their oral cavity health. Even though it was not statistically significant, there was a slight reduction in the BOHSE scores of the intervention group from Day 3 compared to the control group, from a mean of 1.53 at baseline to 1.25.…”

Section: Discussionmentioning

confidence: 99%

“…In the long-term, the use of chlorhexidine may reduce the patient's length of stay in hospital and hospitalisation costs, and improve quality of life for patients and caregivers. (21) Usage of antibiotics and other medical care equipment can be reduced through the use of chlorhexidine; in previous research involving chlorhexidine, it was reported that the mean cost per patient was ten times less than the cost of antibiotics needed. (23) Similarly, chlorhexidine was found to be a safe, cost-effective intervention for ventilator-associated pneumonia without side effects.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

Sharif-Abdullah¹,

Chong²,

Surindar-Kaur³

et al. 2016

smedj

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

Sharif-Abdullah¹,

Chong²,

Surindar-Kaur³

et al. 2016

smedj

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“…27 Aspiration is usually a result of respiratory pathogens and/or alterations in oropharyngeal or gastroesophageal motility. 28 Although feeding tubes deliver nutrition directly into the stomach or intestine, they do not prevent aspiration of oropharyngeal sections and might be associated with an increased risk for oropharyngeal bacterial colonization 27 and aspiration. 29 Aspiration is the most common cause of death after PEG placement, 17 and the use of enteral feeding does not decrease the risk of aspiration.…”

Section: Tube Feeding and Aspiration Pneumoniamentioning

confidence: 99%

“…27,30 Research indicates that one key to preventing aspiration in all patients (including those fed enterally) is good oral hygiene, such as brushing teeth after each meal, daily tooth or denture care, and swabbing of the tongue and oral mucosa to help control risk factors for aspiration. [27][28][29][30][31] Daily oral care (brushing teeth and rinsing with mouthwash twice a day) may help prevent aspiration.…”

Section: Tube Feeding and Aspiration Pneumoniamentioning

confidence: 99%

Enteral Nutrition for Older Adults in Healthcare Communities

Posthauer¹,

Dorner

Friedrich³

2014

Nut in Clin Prac

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Older adults living in healthcare communities (HCCs) have multiple comorbidities and are at increased risk of malnutrition and unintended weight loss. Aging affects nearly every system as well as body composition and structure, causing physiological changes that can affect nutrition status. A significant percentage (56%) of residents who live in nursing facilities require extensive help to eat and have dental problems such as ill-fitting dentures, missing teeth, and swallowing problems, which can lead to inadequate caloric intake and unintended weight loss. Alzheimer disease or dementia is prevalent in both nursing facilities and in assisted living/residential care communities, where it affects 45% of older adults. In cognitively impaired residents, most tube feeding placements occur in the acute care setting and result in significant use of additional healthcare resources, along with high postinsertion mortality rates within 60 days of insertion. Nursing facilities receiving Medicare or Medicaid funding must abide by state and federal regulations and undergo rigorous surveys while balancing complex decisions related to initial placement of feeding tubes. Healthcare professionals must recognize the importance of establishing nutrition treatment goals that are resident centered and that respect the unique values and personal decisions of the older adult. Informed choice, resident-centered care decisions, and the review of living wills and/or advance directives are essential in the decision-making process. After enteral nutrition is started, healthcare practitioners must carefully review the physician's orders and administer and monitor the resident's tolerance, checking for potential complications.

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“…They include medication, altered conscience, neurodegenerative diseases, stroke, esophageal diseases, aging, malnutrition, antibiotics, dry mouth, impaired immune system, dehydration, and smoking [9]. We can classify them into three types of risk: (1) OD with impaired safety of swallow (aspirations); (2) frailty and impaired health status (malnutrition, sarcopenia, impaired immunity, comorbidities, and low functionality); and (3) poor oral health and poor oral hygiene with bacterial colonization by respiratory pathogens [10,11]. Prevention of complications of OD and AP should be directed at all three risk groups.…”

Section: Aspiration Pneumoniamentioning

confidence: 99%

Oral Hygiene, Aspiration, and Aspiration Pneumonia: From Pathophysiology to Therapeutic Strategies

Fernández

Clavé

2013

Curr Phys Med Rehabil Rep

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Oropharyngeal dysphagia (OD) is a very prevalent condition in patients with neurological disorders and in the elderly, and has been shown to play a key role in the pathophysiology of aspiration pneumonia (AP), a frequent and severe complication in patients with OD. The pathophysiology of AP includes three main elements: (1) OD with impaired safety of swallow, aspirations, and frequently, impaired cough reflex; (2) poor oral health and oropharyngeal colonization by respiratory pathogens; and (3) frailty with malnutrition and poor immunity. Respiratory infections and AP lead to readmissions and high mortality among patients at risk, and appropriate management is important to avoid these complications. We have developed a therapeutic intervention including early screening, assessment, and treatment of patients at risk of OD. Those with OD are further assessed and treated for nutritional deficiency, oral hygiene, and oral diseases. This will reduce complications and morbidity and mortality among these patients.

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Prevention of aspiration pneumonia (AP) with oral care

Cited by 79 publications

References 65 publications

The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

Enteral Nutrition for Older Adults in Healthcare Communities

Oral Hygiene, Aspiration, and Aspiration Pneumonia: From Pathophysiology to Therapeutic Strategies

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