The systematic reviews identified below include slightly different findings, so a review of the objective of each review, as well as the patient populations in the included studies, will be important for extrapolating results to a specific setting. Guidelines were identified in DynaMed and in PubMed.
Evidence summary resources
From Mechanical Ventilation entry. In: DynaMed Plus.
Under Adjunctive Therapies > Other Supportive Care
- A systematic review (JAMA 2014) found that oral care with chlorhexidine may reduce lower respiratory tract infections in adults following cardiac surgery, but is not associated with reduction in VAP in non-cardiac surgery patients. The review was limited by the heterogeneity of the settings/populations.
- A systematic review (with heterogeneity) of 6 RCTs concluded that toothbrushing may not reduce risk of ventilator-associated pneumonia in critically ill patients
- Society for Healthcare Epidemiology of America (SHEA) guideline on strategies to prevent ventilator-associated pneumonia in acute care hospitals Infect Control Hosp Epidemiol 2008 Oct;29 Suppl 1:S31
From Joanna Briggs
Oral Hygiene Care: Acute Care Setting. Chu WH. [Evidence Summaries], AN: JBI5215, 2013.
References a systematic review (Cochrane 2013) concluded that use of chlorhexidine was associated with reduction in rate of VAP in adult, but not pediatric, patients.
Oral Care. [Recommended Practices, AN: JBI5264, 2013.
References a systematic review (Am J Crit Care 2007) concluding that toothbrushes can be a source of contamination and should be kept clean.
PubMed
View the results of a search for relevant systematic reviews and meta-analyses:
(“Pneumonia, Ventilator-Associated/prevention and control”[Mesh] OR “Respiration, Artificial/adverse effects”[Mesh]) AND (“Anti-Infective Agents, Local”[nm] OR “oral hygiene”[MeSH Terms]) AND (Meta-Analysis[ptyp] OR systematic[sb])
Additional guideline
Evidence Matters 