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.