The Effectiveness of Chlorhexidine 0.2% Mouthwash vs. Chlorhexidine 0.2% Mouthwash and Toothbrush in Preventing Ventilator Associated Pneumonia a Randomized Controlled Trial

Background: Intensive care unit patients are fragile and highly susceptible to infections. Respiratory infections, especially ventilator-associated pneumonia, are the most frequent infectious complications in critically ill patients. Evidence-based patient care treatment practices have been developed by the Center for Disease Control and Prevention to decrease ventilator-associated pneumonia cases. Sixty percent of cases of ventilator-associated pneumonia have been reduced by simple oral routine care.

Aims: To compare the effectiveness of 0.2% chlorhexidine mouthwash solution and chlorhexidine mouth wash with tooth brush and their association in demographic variables in patient admitted in critical care unit.

Methodology: A RCT was conducted from November 2020 to February 2021 in the patient under mechanical ventilation. Ethical clearance and written consent were obtained before collecting information. 30 participants in each control and experimental group were selected by applying the convenient sample technique method. Data was collected using the self-created Performa and the main tool, the Clinical Pulmonary Infection Score, to detect ventilator-associated pneumonia.

Analysis: The data gathered were analyzed and interpreted according to the objective of the study using SPSS version 20. Descriptive statistics were used to find out the demographic result, and the non-parametric Chi-square test was used to compare the data.

Results: Out of 60 participants, majority of patient belongs to 51-60 years, i.e. 11 (36.67%) in control group and 61-70 years, i.e. 13 (43.33%) experimental group. Patients who received chlorhexidine with tooth brushing intervention had higher Clinical pulmonary Infection Score values and higher rate of Ventilator Associated Pneumonia occurrence in experimental group 3(10%) than in control group 1(3.33%).

Conclusion: Combining tooth brushing with 0.2% chlorhexidine did not provide additional benefits over 0.2% chlorhexidine alone. There is no significant reduction in the rate of ventilator-associated pneumonia by applying 0.2% chlorhexidine with toothbrushing.