Effectiveness of 2% chlorhexidine mouthwash in minimizing ventilator-associated pneumonia in ventilated patients: evidence-based practice

Abstract

Background & objectives: Ventilator-associated pneumonia (VAP) is an intensive care acquired iatrogenic pulmonary infection that affects the pulmonary parenchyma of patients who are mechanically ventilated. Worldwide, incidence of VAP can increase the mortality rate and delay therapy progress in ventilated patients; therefore, it is necessary to identify the best practice for reducing incidence of VAP. Oral hygiene is one of the basic procedures for minimising respiratory infection and reducing VAP, with 2% chlorhexidine being an oral care solution that is used to protect and enhance the mouth environment. Also, it can be used to reduce the colonisation of organisms that lead to infection.

This paper aims to determine whether the usage of 2% chlorhexidine mouthwash is effective in reducing the incidence of VAP.

Methodology: This paper is a part of literature review regarding the effectiveness of 2% chlorohexidine mouthwash in prevention of VAP. The review was conducted over three months (September–December 2020). In this review, a systematic search through the MEDLINE and Cumulative Index of Nursing and Allied Health (CINAHL) databases was undertaken to determine if chlorhexidine reduces VAP incidence.

Results: The results showed that 2% chlorhexidine is effective in reducing the incidence of VAP by diminishing the colonisation of pathogens in the mouth cavity and in the airway.

Conclusion: The use of 2% chlorhexidine as a mouthwash agent demonstrates an appropriate effect in reducing pathogen colonisation and reducing VAP incidence. Therefore, health professionals should make oral health care (OHC) a priority in ICU patients to reduce mortality among ventilated patients and improve the performance of the health service.

Key words: Ventilation, mechanical; Adult patient; Ventilator; Oral care; Mouth rinse; Chlorhexidine; Ventilator associated pneumonia; VAP

Citation: Al-Qarni HH. Effectiveness of 2% chlorhexidine mouthwash in minimizing ventilator-associated pneumonia in ventilated patients: evidence-based practice. Anaesth. pain intensive care 2021;25(5):633-637

DOI: 10.35975/apic.v25i5.1631

Received: February 10, 2021, Reviewed: June 18, 2021, Accepted: August 23, 2021