Oral hygiene with chlorhexidine and increase in time of hospitalization in an Intensive Care Unit
DOI:
https://doi.org/10.18554/refacs.v10i4.5969Keywords:
Chlorhexidine, Dental staff, Intensive care unitsAbstract
Objective: to evaluating the effect of an oral hygiene routine with chlorhexidine solution in the length of stay of intensive care patients, comparing the number of days of permanence in the intensive care unit before and after protocol implementation. Methods: this is a quasi-experimental study held in 2020, which analyzed 126 medical records, which were divided into two groups (63 each) according to the use of chlorhexidine 0.12% in an oral hygiene routine: before use (2004-2010) and after use (2011-2020). The selection of patients was based on pairing by sex, age, underlying disease and comorbidities. Results: the mean age was 55 years old (±18,76). The median length of stay before and after the new oral care routine were 3.0 and 5.0 days, respectively, and a significant increase in duration of hospitalization after routine implementation was observed (OR=2.82; CI95%=1.06-4.87; p=0.033). Conclusion: after implementing the oral hygiene routine using a chlorhexidine, the length of stay of patients in the intensive care unit significantly increased.
References
Teixeira KCF, Santos LM, Azambuja FG. Análise da eficácia da higiene oral de pacientes internados em unidade de terapia intensiva em um hospital de alta complexidade do sul do Brasil. Revista de Odontologia da Universidade Cidade de São Paulo [Internet]. 2019[citado em 07 jul 2021];31(2):134-44. DOI: https://doi.org/10.26843/ro_unicidv3122019p134-144
Quadros CTP, Silva MCV, Carvalho MF, Santos-Silva ME, Meireles IB, Silva CRL et al. Importância dos cuidados de higiene oral realizados em pacientes intubados no centro de terapia intensiva. Saúde Coletiva (Barueri) [Internet]. 2019[citado em 03 jul 2021];9(51):1933-8. DOI: https://doi.org/10.36489/saudecoletiva.2019v9i51p1933-1938
Bellissimo-Rodrigues WT, Menegueti MG, Gaspar GG, Souza, HCC, Auxiliadora-Martins M, Basile-Filho, A et al. Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial. International Dental Journal [Internet]. 2018 [citado em 22 ago 2021]; 68(6):420-7. DOI: https://doi.org/10.1111/idj.12397
Galgut PN. Periodontal disease and poor health outcomes. BMJ [Internet]. 2010 [citado em 07 jul 2021]; 340:c2735. DOI: https://doi.org/10.1136/bmj.c2735
Shiraishi A, Yoshimura Y, Wakabayashi H, Tsuji Y. Prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients: Implications for oral sarcopenia. Clinical Nutrition [Internet]. 2018 [citado em 08 jul 2021];37(1):204-7. DOI: https://doi.org/10.1016/j.clnu.2016.12.002
Barnes CM. Dental hygiene intervention to prevent nosocomial pneumonias. Journal of Evidence Based Dental Practice [Internet]. 2014 [citado em 08 jul 2021];14:103-14. DOI: https://doi.org/10.1016/j.jebdp.2014.02.002
Silva-Júnior JM, Chaves RCDF, Corrêa TD, Assunção MSCD, Katayama HT, Bosso FE et al. Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil. Revista Brasileira de Terapia Intensiva [Internet]. 2020 [citado em 07 ago 2021];32(1):17-27. DOI: https://doi.org/10.5935/0103-507X.20200005
Deschepper M, Waegeman W, Eeckloo K, Vogelaers D, Blot S. Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study. Intensive Care Medicine [Internet]. 2018 [citado em 12 ago 2021];44(7):1017-1026. DOI: https://doi.org/10.1007/s00134-018-5171-3
Klompas M, Speck K, Howell MD, Greene LR, Berenholtz SM. Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis. JAMA Internal Medicine [Internet]. 2017[citado em 01 jul 2021]; 174(5):751-61. DOI: 10.1001/jamainternmed.2014.359.
Price R, MacLennan G, Glen J. Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis. BMJ [Internet]. 2014 [citado em 08 set 2020]; 348. DOI: https://doi.org/10.1136/bmj.g2197
Bellissimo-Rodrigues WT, Menegueti MG, Macedo LD, Basile-Filho A, Martinez R, Bellissimo-Rodrigues F. Oral mucositis as a pathway for fatal outcome among critically ill patients exposed to chlorhexidine: post hoc analysis of a randomized clinical trial. Critical Care [Internet]. 2019 [citado em 07 jul 2021]; 23(1):1-3. DOI: https://doi.org/10.1186/s13054-019-2664-6
Pobo A, Lisboa T, Rodriguez A, Sole R, Magret M, Trefler S et al. A randomized trial of dental brushing for preventing ventilator-associated pneumonia. Chest [Internet]. 2009[citado em 01 jul 2021]; 136(2):433-9. DOI: https://doi.org/10.1378/chest.09-0706
Lorente L, Lecuona M, Jiménez A, Palmero S, Pastor E, Lafuente N et al. Ventilator-associated pneumonia with or without toothbrushing: a randomized controlled trial. European Journal of Clinical Microbiology & Infectious Diseases [Internet]. 2012[citado em 15 jul 2021]; 31(10):2621-9. DOI: https://doi.org/10.1007/s10096-012-1605-y
Gershonovitch R, Yarom N, Findler M. Preventing Ventilator-Associated Pneumonia in Intensive Care Unit by improved Oral Care: A Review of Randomized Control Trials. SN Comprehensive Clinical Medicine [Internet]. 2020 [citado em 15 jul 2021]; 2:727-33. DOI: https://doi.org/10.1007/s42399-020-00319-8
Krautheim AB, Jermann THM, Bircher AJ. Chlorhexidine anaphylaxis: case report and review of the literature. Contact Dermatitis [Internet]. 2004 [citado em 15 jul 2021]; 50(3):113-6. DOI: https://doi.org/10.1111/j.0105-1873.2004.00308.x
Munro CL, Grap MJ, Jones DJ, McClish DK, Sessler CN. Chlorhexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. American Journal of Critical Care [Internet], 2009 [citado em 09 ago 2021]; 18(5):428-37. DOI: https://doi.org/10.4037/ajcc2009792
Associação de Medicina Intensiva Brasileira (AMIB). Procedimento Operacional Padrão (POP): Higiene bucal em pacientes internados em UTI adulto ou pediátrica [internet]. 2019. [citado em 07 out 2020]. Disponível em https://www.amib.org.br/fileadmin/user_upload/amib/2019/novembro/29/2019_POP-HB_em_papel-carta_AMIB.pdf
Blum DFC, Silva JAS, Baeder FM, Della-Bona A. The practice of dentistry in intensive care units in Brazil. Revista Brasileira de Terapia Intensiva [Internet]. 2018 [citado em 09 set 2020];30(3):327. DOI: https://doi.org/10.5935/0103-507X.20180044
Cuthbertson BH, Dale CM. Less daily oral hygiene is more in the ICU: yes. Intensive Care Medicine [Internet]. 2021[citado em 23 jul 2021]; 47:328-30. DOI: https://doi.org/10.1007/s00134-020-06261-6
Labeau SO, Conoscenti E, Blot SI. Less daily oral hygiene is more in the ICU: not sure. Intensive Care Medicine [Internet]. 2021[citado em 07 jul 2021]; 47:334-336. DOI: https://doi.org/10.1007/s00134-020-06021-6
Malta DC, Silva MMAD. As doenças e agravos não transmissíveis, o desafio contemporâneo na Saúde Pública. Ciências & Saúde Coletiva [Internet]. 2018[citado em 05 jun 2021]; 23(5):1350. DOI: https://doi.org/10.1590/1413-81232018235.31552017
Ministério do Planejamento, Orçamento e Gestão (Br). Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Saúde. Percepção do estado de saúde, estilos de vida e doenças crônicas. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística[Internet]. 2013 [citado em 08 jul 2021].
Schmidt MI, Duncan BB, Silva GA, Menezes AM, Monteiro CA, Barreto SM et al. Chronic non-communicable diseases in Brazil: burden and current challenges. The Lancet [Internet]. 2011 [citado em 12 jun 2021]; 377(9781):1949-61. DOI: https://doi.org/10.1016/S0140-6736(11)60135-9
Duarte EC, Barreto SM. Transição demográfica e epidemiológica: a Epidemiologia e Serviços de Saúde revisita e atualiza o tema. Epidemiologia e Serviços de Saúde [Internet]. 2012 [citado em 08 jul 2021]; 21(4):529-32.DOI:http://dx.doi.org/10.5123/S1679-49742012000400001
Alwan A. Global status report on noncommunicable diseases 2010. World Health Organization [Internet]. 2011[citado em 22 set 2021].
Mansur ADP, Favarato D. Mortalidade por doenças cardiovasculares em mulheres e homens nas cinco regiões do Brasil, 1980-2012. Arquivos Brasileiros de Cardiologia [Internet]. 2016[citado em 07 jul 2021];107(2):137-146. DOI: https://doi.org/10.5935/abc.20160102
Guimarães RM, Andrade SSCDA, Machado EL, Bahia CA, Oliveira MMD, Jacques FVL. Diferenças regionais na transição da mortalidade por doenças cardiovasculares no Brasil, 1980 a 2012. Revista Panamericana de Salud Publica [Internet]. 2015 [citado em 07 jul 2021];37(2):83-89.
Cruz MR, Zamora VE. Ventilação mecânica não invasiva. Revista Hospital Universitário Pedro Ernesto [Internet]. 2013[citado em 01 jun 2021];12(3). DOI: 10.12957/rhupe.2013.7535
Bini R, Pletsch AHM, Reis ABO, Souza F, Cuiabano TK. Perfil dos idosos atendidos pela fisioterapia na UTI geral do Hospital Geral Universitário–HGU de Cuiabá/MT. Journal of Health Sciences [Internet]. 2018[citado em 07 set 2021];20(1):25-8. DOI: https://doi.org/10.17921/2447-8938.2018v20n1p25-28
Lobo LAC, Canuto R, Dias-da-Costa JS, Pattussi MP. Tendência temporal da prevalência de hipertensão arterial sistêmica no Brasil. Cadernos de Saúde Pública [Internet]. 2017[citado em 07 set 2021]; 33:e00035316. DOI: https://doi.org/10.1590/0102-311X00035316
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 JOURNAL FAMILY, CYCLES OF LIFE AND HEALTH IN SOCIAL CONTEXT
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Each of the authors of the manuscript must complete and sign a copy of Statement of Responsibility and Copyright Transfer Agreement, which must be attached, by the submitting author, in step 4 of the submission process in the journal system (Click on the "Browse" option, select the file that should be inserted in pdf format, click on the "Download" button, in the "Title" field type: Declaration of responsibilities, then click the "Save and Continue" button and proceed with the submission process.
Note: Including scanned signature will not be accepted. Each author of the manuscript must complete a declaration individually.
REFACS de Universidade Federal do Triângulo Mineiro está licenciado com uma Licença Creative Commons - Atribuição-NãoComercial 4.0 Internacional.
Baseado no trabalho disponível em www.uftm.edu.br.
Podem estar disponíveis autorizações adicionais às concedidas no âmbito desta licença em http://www.uftm.edu.br/refacs.
