Abstract
Background: One of the serious complications in patients undergoing mechanical ventilation is called ventilator-associated pneumonia (VAP). Effective oral hygiene agents are essential to reduce the colonization of pathogenic microorganisms in the oral cavity and prevent VAP. Toothbrushing with 0.12% chlorhexidine and fluoride toothpaste are commonly used agents, but their effectiveness in reducing microorganism colonization still needs further investigation.
Methods: The study design was a single-blind randomized clinical trial involving 20 patients undergoing mechanical ventilation, divided into two groups: one group received 0.12% chlorhexidine, and the other group used fluoride-based toothpaste. Measurement of microorganism colonies in non-bronchoscopy bronchoalveolar lavage (NBBAL) rinses was performed before and after the intervention on day 4. An independent samples t-test was used to analyze the data. Small sample sizes are limited by low statistical power, restricted generalizability, and a high risk of bias. Therefore, researchers must acknowledge these limitations and recommend further studies with larger samples for stronger and more generalizable results.
Results: The results showed that using 0.12% chlorhexidine significantly reduced the number of colonies of microorganisms in bronchoalveolar lavage (BAL) compared with fluoride-based toothpaste. Chlorhexidine showed a greater reduction in microorganism colonies and was more effective in reducing Clinical Pulmonary Infection Score (CPIS).
Conclusion: In patients on mechanical ventilation, 0.12% chlorhexidine is more efficient than fluoride toothpaste at lowering the colonies of microorganisms, which could help avoid VAP.
Dodi Franata, Faisal Muchtar, Ari Santri Palinrungi, Muhammad Rum, Andi Adil, Hisbullah
