To compare the frequency of ventilator-associated pneumonia among mechanically ventilated patients with four- hourly chlorhexidine mouthwash VS six-hourly chlorhexidine mouthwash.

Abstract

Objective: To compare the frequency of ventilator-associated pneumonia among mechanically ventilated patients with four hourly chlorhexidine mouthwash VS six hourly chlorhexidine mouthwash. Study Design: Randomized Controlled Trial. Setting: Surgical Intensive Care Unit of the Department of Anesthesia, Shifa International Hospital, Islamabad, Pakistan. Period: January 2020 to June 2020. Methods: Eighty patients admitted to ICU and mechanically ventilated for at least 48 hrs were randomly allocated, and 40 patients were treated with chlorhexidine mouthwash four-hourly per day group1, and 40 received chlorhexidine mouthwash six-hourly group2. The primary researcher followed patients for up to 7 days. Lower respiratory tract specimens were obtained on admission, and after 48 hrs of intubation, findings were entered in proforma. Results: The average age of the patients in group 1 was 37.55±10.16 years and in group 2 was a 38.65±9.25 year. There were 38(47.5%) male and 42(52.5%) female. The frequency of VAP was not significant between groups (11.25% vs 6.25%, p=.23). It was observed that the rate of VAP was not significant between groups in all age stratification. Gender stratification was performed and observed that no difference was found between groups. The frequency of VAP in females in group 1 was 7 (35%) and 4 (18.2%) in group 2, with p-value=0.21 and Chi-square=1.53. The frequency of ventilator-associated pneumonia differed between groups for males in group 1 (35%) and 1 (5.6%) in group 2, with p-value=0.61 and Chi-square=0.25. Conclusion: Our study concludes that oral hygiene care incorporating chlorhexidine mouthwash effectively reduces the development of VAP in adults in ICU. We found no difference between the efficacy of four hourly and six-hourly chlorhexidine mouth wash in VAP frequency.