Oral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: Randomised, controlled and double blind trial

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dc.contributor.authorKusahara, Denise Miyuki [UNIFESP]
dc.contributor.authorPeterlini, Maria Angélica Sorgini [UNIFESP]
dc.contributor.authorPedreira, Mavilde da Luz Gonçalves [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:27:58Z
dc.date.available2016-01-24T14:27:58Z
dc.date.issued2012-11-01
dc.description.abstractPurpose: To test the effectiveness of oral care with 0.12% chlorhexidine in decreasing ventilator-associated pneumonia in critically ill children.Methods: Prospective, randomised, controlled, double-blind clinical trial performed in a paediatric critical care unit at a university hospital. the sample was composed of 96 mechanically ventilated children randomly allocated to the chlorhexidine group (oral care with a toothbrush and an antiseptic gel twice a day) and the placebo group (oral care with a toothbrush and a non-antiseptic gel twice a day). Microbiological analyses of oropharyngeal and tracheal secretions were performed 24, 48 and 96 h after intubation. Chi-square, Fischer's exact and Mann-Whitney tests were applied (p <= 0.05).Results: the chlorhexidine group was composed of 46 children, and the placebo group consisted of 50 children. Within these samples, 15 (32.6%) children in the chlorhexidine group and 16 (32.0%) children in the placebo group developed ventilator-associated pneumonia (p = 0.949). Children in the chlorhexidine group without potentially pathogenic microflora in their oropharynx 24 h after mechanical ventilation presented with fewer episodes of ventilator-associated pneumonia (p = 0.019). the pathogen colonization profile of children with ventilator-associated pneumonia in the chlorhexidine group included Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. in the placebo group, Pseudomonas aeruginosa and Escherichia coli were the predominant potentially pathogenic microorganisms. the intervention did not influence paediatric intensive care unit mortality (p = 0.425), hospital length of stay (p = 0.143), or paediatric intensive care unit length of stay (p = 0.177).Conclusions: the use of 0.12% chlorhexidine did not significantly modify the VAP incidence in a sample of mechanically ventilated children. (C) 2012 Elsevier B.V. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Enfermagem, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Enfermagem, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipIDFAPESP: 04-13361-2
dc.format.extent1354-1363
dc.identifierhttps://dx.doi.org/10.1016/j.ijnurstu.2012.06.005
dc.identifier.citationInternational Journal of Nursing Studies. Oxford: Pergamon-Elsevier B.V., v. 49, n. 11, p. 1354-1363, 2012.
dc.identifier.doi10.1016/j.ijnurstu.2012.06.005
dc.identifier.issn0020-7489
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/35470
dc.identifier.wosWOS:000311770300004
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofInternational Journal of Nursing Studies
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectVentilator-associated pneumoniaen
dc.subjectOral hygieneen
dc.subjectChlorhexidineen
dc.subjectCritical careen
dc.subjectPaediatric nursingen
dc.titleOral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: Randomised, controlled and double blind trialen
dc.typeinfo:eu-repo/semantics/article
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