Oral Care Interventions and Ventilator Associated Pneumonia in Critically Ill Children
Condition: Ventilator Associated Pneumonia
MeSH terms: Pneumonia; Pneumonia, Ventilator-Associated
Study type: Interventional
Phase: Phase 1

Summary: 
      This experimental study aims to verify the influence of the oral hygiene performance with
      chlorhexidine digluconate 0.12% in the development of VAP in children. The data collection
      begun in April, 2005 during the performance of the masters degree course dissertation
      entitled "Clinical study about the effect of the oral hygiene with chlorhexidine digluconate
      0.12% in the oropharynx colonization of children in intensive care", being performed in a
      PICU of nine beds in a university hospital in the city of São Paulo, after approval of the
      Research Ethics Committee of the institution. The study is composed by three types of
      variables: Independent variable, dependent variables, and complementary variables. The
      categorical variables will be analyzed in accordance with the Person's Chi-Square test of or
      Fisher's exact test. The numerics will be submitted to the analysis of variance ANOVA or
      Kruskall Wallis. For variables with heterogeneous distribution between the groups, the
      multivariate analysis will be applied to the evaluation of the influence in the determination
      of the development risk of the dependent variable. The rejection level will be fixed in 0.05
      of the nullity hypothesis.
    

Detailed description: 
      Recent progress in identification of oral microorganisms has shown that the oropharynx can be
      a site of origin for dissemination of pathogenic organisms to distant body sites, such as the
      lungs. THe aims of the study were to compare the oropharyngeal microbiological profile, VAP
      incidence, duration of mechanical ventilation, and length of stay in the intensive care unit
      of children receiving mechanical ventilation who had pharmacological or nonpharmacological
      oral care.

      A randomized and controlled study has been performed in a pediatric intensive unit in São
      Paulo, Brazil. The children are randomly assigned to an experimental group that received oral
      care with use of 0.12% chlorhexidine digluconate or a control group that received oral care
      without an antiseptic. Oropharyngeal and tracheal secretions were collected and cultured on
      days 0, 2, and 4, and at discharge.
    

Intervention name(s): 0.12% Chlorhexidine Digluconate; Toothbrushing
Intervention type(s): Drug; Other
Intervention description(s): Oral care with 0.12% Chlorhexidine Digluconate and toothbrushing is realized twice a day and took about 10 minutes to complete, depending on the child's acceptance and clinical conditions.; Gel is applied on a toothbrush, and the teeth are cleaned in quadrants; all teeth surfaces are cleaned (vestibular, lingual, occlusal, and incisal). After each quadrant is cleaned, 10 mL of water (dispensed via a syringe) is used to rinse the quadrant and continual aspiration is used to remove all the gel and debris. After all the teeth are cleaned, the ventral surface of the tongue is brushed with posteriorto-anterior movements.
Intervention MeSH terms: Chlorhexidine; Chlorhexidine gluconate
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Prevention
Keywords: Oral care.; Chlorhexidine.; Pediatric Nursing; Intensive Care; Nosocomial infection; Pneumonia; Oropharyngeal colonization; Tracheal colonization