Use of toothbrushing in conjunction with chlorhexidine for preventing ventilator-associated pneumonia: A random-effect meta-analysis of randomized controlled trials

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dc.authorid0000-0003-1555-3591
dc.authorid0000-0003-4384-3975
dc.authorscopusid56608188300
dc.authorscopusid57224494344
dc.authorwosidSozkes, Sarkis/ABA-6103-2020
dc.contributor.authorSözkes, Serda
dc.contributor.authorSözkes, Sarkis
dc.date.accessioned2022-05-11T14:16:07Z
dc.date.available2022-05-11T14:16:07Z
dc.date.issued2021
dc.departmentFakülteler, Çorlu Mühendislik Fakültesi, Biyomedikal Mühendisliği Bölümü
dc.description.abstractObjective The oral cavity with poor hygiene is a reservoir of a complex community of commensal and pathogenic bacteria. Improved oral hygiene (OH) may reduce the incidence of ventilator-associated pneumonia (VAP); however, research on the efficacy of different OH treatments and their potential synergistic effects has remained inconclusive. The objective of this study was to examine whether in patients on mechanical ventilation, using a toothbrushing (T) in conjunction with chlorhexidine (CHX), as opposed to only CHX, reduced the incidence of VAP. Method A random-effect meta-analysis of randomized clinical trials, which compare the effect of CHX+T (intervention) with CHX (control) on the risk of VAP, was conducted. The Mantel-Haenszel model was used to determine the mean differences (MD), relative risks (RR) and 95% confidence intervals (CI). Results Seven studies with 1424 patients were included. Oral care with CHX+T reduced the incidences of VAP (RR = 0.67; CI = [0.50, 0.88], p = 0.005) compared with that with CHX alone. The former also reduced the duration of mechanical ventilation (MD = -1.38; CI = [-2.43, -0.33], p = 0.01) and length of stay in the ICU (MD = -1.47; CI = [-2.74, -0.20], p = 0.02), although the risk of ICU mortality did not reduce (RR = 0.87, 95% CI = [0.72, 1.04], p = 0.17). Conclusions Toothbrushing along with CHX significantly reduced the risk of VAP. Further well-designed randomized controlled trials with a careful focus on the OH are needed to fully establish the advantage of toothbrushing along with CHX for reducing the risk of VAP.
dc.identifier.doi10.1111/idh.12560
dc.identifier.issn1601-5029
dc.identifier.issn1601-5037
dc.identifier.pmid34687588
dc.identifier.scopus2-s2.0-85118244907
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1111/idh.12560
dc.identifier.urihttps://hdl.handle.net/20.500.11776/6185
dc.identifier.wosWOS:000712955700001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorSözkes, Sarkis
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofInternational Journal of Dental Hygiene
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectchlorhexidine
dc.subjectmeta-analysis
dc.subjectoral hygiene
dc.subjectventilator-associated pneumonia
dc.subjectCare
dc.titleUse of toothbrushing in conjunction with chlorhexidine for preventing ventilator-associated pneumonia: A random-effect meta-analysis of randomized controlled trials
dc.typeArticle

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