Effects of Oral Care Using Chlorhexidine Gluconate on Ventilator-Associated Pneumonia in the Intensive Care Unit / 병원감염관리

ABSTRACT

BACKGROUND: This study was aimed to identify the effect of oral care using 0.1% chlorhexidine gluconate (CHG) on ventilator-associated pneumonia (VAP) in the intensive care unit (lCU). METHODS: A total of 82 ventilated patient were enrolled in this prospective clinical trial performed during the 6-month period from October, 2005 through March, 2006. oral care was performed on the patients three times a day with 0.1% CHG for the study group and with 0.9% saline for the control group. To evaluate the colonization of potential pathogens, sputum cultures were taken on the first day of ventilation and followed on days 3, 5, 7, and 14. RESULTS: The overall incidence rate of YAP was 0.359 in the CHG-treated group compared to 0.116 in the NaCI-treated group (P=0.017). Likewise, 1000 device-day incidence rate of YAP was significantly lower in the CHG-treated group than in the NaCI-treated group (P=0.0396). However, among the patients whose initial sputrm cultures were positive , both the incidence rate (P=0.114) and 1000 device-day incidence rate (P=0.361) were not statistically significant. The average time from the day of ventilation to the onset of VAP among the patients whose initial sputrm cutures were positive was 14 days in the CHG-treated group and 9 days in the NaCI-treated group, but the difference was not statistically significant (P=0.169). CONCLUSION: An oral care with 0.1% CHG was helpful in controlling VAP in the ICU patients, but the effectiveness of CHG could not be confirmed in the patients whose initial sputrm cultures were positive.