The Effect of Oral Decontamination Plan on the Occurrence of Ventilator Associated Pneumonia in Icu Patients: A Double-Blind Clinical Trial

Abstract

Aim: Oral colonization and microaspiration of secretions to the lower respiratory tract are two important processes in infectious pathogens associated with mechanical ventilation. In ICU patients, hospital pneumonia is the most common and deadly hospital infection. The purpose of this study was to investigate the effect of using Nanosil mouthwash in the form of an oral decontamination plan on the clinical pulmonary infection score, which indicates the incidence of ventilator associated pneumonia. Materials & Method: This research is a clinical, interventional, two-group, randomized, double blind trial. Eighty patients undergoing mechanical ventilation, who were admitted less than 48 hours ago and were eligible for inclusion in the study, were selected and randomly assigned to the two control and experimental groups. An oral decontamination plan using Nanosil mouthwash was carried out for 5 days, every 8 hours, for a duration of 3-5 minutes for the experimental group, and the same plan was carried out for the control group using chlorhexidine mouthwash. On the first and fifth days, the Modified Clinical Pulmonary Infection Score (MCPIS) will be completed to measure ventilator associated pneumonia and the expected outcome of the occurrence or non-occurrence of ventilator-associated pneumonia will be analyzed. Results: There was no significant difference in terms of age, sex, background disease, history of smoking, MCPIS initial score, SOFA score and GCS score between the two groups (p > 0.05). In both groups, the mean score of SOFA and GCS increased significantly within five days (p < 0.05). Also, after five days from the start of the study, the mean score of MCPIS (1.2 +/- 0.1 vs. 3.5 +/- 0.3, p < 0.001) and pneumonia incidence (2.7 vs 23.7, p = 0.008) decreased significantly in both groups. However, the mortality rate on the first and fifth days was equal in both groups (p > 0.05). Conclusion: The use of Nanosil mouthwash in the form of an oral decontamination plan for ICU patients reduces the incidence of ventilator associated pneumonia, but further studies and more samples are required to solidify the results.