Prevention of Ventilator Associated Pneumonia With Toothbrushing in Oral Care of Critically Ill Mechanically Ventilated Patients

Study Overview
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Brief Summary
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Effect of toothbrushing in oral care of mechanically ventilated critically ill patients on prevention of ventilator associated pneumonia

Detailed Description
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Prospective, before and after study in 5 Intensive Care Units (ICUs) of a university hospital. The before period (control phase, 6 months): standard oral care 3 times a day in every consecutive intubated patients in the participating ICUs The interphase period (1 month): formal training of all the nurses, physicians and residents on the use of toothbrushing during oral care The after period: (study phase, 6 months): standard oral care with tooth brushing 3 times a day in every consecutive intubated patients in the participating ICUs

Official Title
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Prevention of Ventilator Associated Pneumonia With Toothbrushing in Oral Care of Critically Ill Mechanically Ventilated Patients

Conditions
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Critical Care, Mechanical Ventilation, Ventilator Associated Pneumonia Prevention, Toothbrushing, Oral Care

Intervention / Treatment
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* Other: Toothbrushing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients Intubated mechanically ventilated ICU patient Platelets count >50G/L Exclusion Criteria: Edentulous patients

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Toothbrushing|Toothbrushing associated with standard oral care in mechanically ventilated patients|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nosocomial ventilator associated pneumonia | Presence of at least two signs (body fever greater than 38°C; leukocytosis greater than 12000/ml or leukopenia below 4000/ml, purulent pulmonary secretions) associated with the appearance of a new infiltrate or modification of an existing infiltrate on chest-X-ray. Confirmation by a lower respiratory tract sample using a quantitative culture with a predefined positive threshold. Hospital-acquired pneumonia was defined as a pneumonia that occurs at least 48 hours after admission, which was not incubating at time of admission (Am J Respir Crit Care Med 2005; 171, 388-416). | at Day-28 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tracheobronchitis | Association of at least two signs (fever above 38.0°C, Leucocytosis above 12000/ml or purulent pulmonary secretions) with isolation of bacteria in a lower respiratory tract sample without modification of chest-X-Ray. | at Day-28 | 
| ICU length of stay |  | at Day-90 | 
| ICU mortality |  | at Day-90 | 
| Hospital mortality |  | at Day-90 | 
| Antibiotic free days |  | at Day-90 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Critical care, Mechanical ventilation, Ventilator associated pneumonia, Oral care