Tuesday December 13, 2005
Oral care in ICU

Oral care is an integral part of ICU care. One recent study showed decrease in ventilator associated pneumonia (VAP) rate from 5.6 VAPs/1000 ventilator days to 2.0 VAPs/1000 ventilator days. Due to significance, one clinical trial is comparing a program of meticulous oral care using oral assessments taught by a dentist and dental hygienist with the standard nursing care typically given in ICUs. A recent study from Dutch investigators showed that 2% chlorhexidine every six hours by swabbing it onto the buccal cavity decreases VAP significantly and is way more effective than traditional .12% chlorhexidine .

See one sample ORAL CARE FOR INTUBATED PATIENTS protocol - from London Health Sciences Centre, Canada.

References:

1. You can make a difference in 5 minutes - Evidence-Based Nursing 2004; 7:102-103
2. Oral Care to Reduce Mouth and Throat Infections in Critically Ill Patients - clinicaltrials.gov
3. Oral Care Interventions in Critical Care: Frequency and Documentation - American Journal of Critical Care. 2003;12: 113-118
4. Chlorhexidine 2% Preparation Reduces the Incidence of Ventilator-Associated Pneumonia - 44th Interscience Conference on Antimicrobial Agents and Chemotherapy: Abstract 3717. Presented Oct. 31, 2004 - via medscape.com with free registration)