Munro et al.(6)
|
To describe the effects of CHX, toothbrush, and their combination in the development of MVAP in ICU patients under MV |
RCT |
547/Mixed ICU |
(1) 0.12% CHX solution twice a day (2) toothbrush three times a day (3) 0.12% CHX two times a day + toothbrush three times a day |
Control group along with usual care |
CHX reduces MVAP, but brushing does not |
B |
2C |
Pobo et al.(7)
|
To evaluate the addition of the electric toothbrush to oral hygiene in order to reduce MVAP |
RCT with single blinding |
147/Mixed ICU |
0.12% CHX solution every 8 hours |
Electric toothbrush |
The addition of the electric toothbrush to standard hygiene with 0.12% CHX is not effective in preventing MVAP |
B |
2B |
Scannapieco et al.(8)
|
To determine the minimum frequency (one or two times a day) of 0.12% CHX to reduce oral colonization by pathogens in patients under MV |
RCT double-blind |
175/Trauma ICU |
0.12% CHX one or two times a day |
Placebo |
The use of 0.12% CHX reduces the number ofStaphylococcus aureus, but does not reduce the proportional number of Pseudomonas, actinobacteria or enteral species in the bacterial plaque |
B |
2B |
Tantipong et al.(11)
|
To determine the efficacy of oral decontamination with a solution of 2% CHX for the prevention of MVAP |
RCT |
207/Mixed ICU |
CHX 2% solution four times a day |
Saline solution |
Oral decontamination with 2% CHX is an effective and safe method for prevention of MVAP |
B |
2C |
Houston et al.(12)
|
To evaluate the efficacy of oral use of 0.12% CLX in decreasing colonization of the respiratory tract and hospital-acquired pneumonia in patients submitted to cardiac surgery |
ECR |
591/Surgical ICU |
0.12% CHX solution two times a day |
Listerine |
Rates of MVAP were lower in patients treated with CHX |
B |
2B |
Grap et al.(13)
|
To document the efficacy of a single application of CHX in the oral cavity immediately after intubation on the oral microbiota and MVAP |
RCT |
34/Mixed ICU |
0.12% CHX solution two times a day |
Usual care Bicarbonate four times a day |
Use of CHX during post-intubation may attenuate or retard the development of MVAP |
B |
2B |
Belissimo-Rodrigues et al.(14)
|
To evaluate the efficacy of the oral application of a solution of 0.12% CHX for the prevention of respiratory infection in the ICU |
RCT double-blind |
194/Mixed ICU |
0.12% CHX solution three times a day |
Placebo |
0.12% CHX does not impede respiratory tract infection, but can retard its appearance |
B |
2B |
Lorente et al.(15)
|
Comparar a incidência de PAVM de pacientes críticos que receberam cuidados bucais com e sem escovação manual dos dentes |
RCT |
436/Mixed ICU |
Group A corresponded to 0.12% CHX without mechanical brushing Group B corresponded to 0.12% CHX with mechanical brushing |
|
There were no statistically significant results |
B |
2B |
Fourrier et al.(16)
|
To compare the incidence of MVAP in critically ill patients who received oral care with and without manual brushing of the teeth |
RCT with single blinding |
60/Mixed ICU |
0.2% CHX gel three times a day |
Usual care Bicarbonate four times a day |
Decontamination with 0.2 % CHX decreased oral bacterial colonization and can reduce the incidence of infections in patients under MV in the ICU |
B |
2B |
Fourrier et al.(17)
|
To document the efficacy of decontamination of the dental plaque and oral cavity with use of CHX on the rates of hospital-acquired bacteremia and respiratory infections acquired in the ICU |
RCT double-blind |
228/Mixed ICU |
0.2% CHX gel three times a day |
Placebo |
Decontamination of bacterial plaque and gums with CHX reduced the colonization of the oropharynx by aerobic pathogens in ventilated patients, but was insufficient in reducing respiratory infections |
B |
2B |
Panchabhai et al.(18)
|
To evaluate if 0.2% CHX reduces the incidence of MVAP in the ICU |
RCT |
512/General ICU |
0.2% CHX solution two times a day |
0.01% potassium permanganate |
The use of 0.2% CHX did not reduce the incidence of NP in ICU patients, but meticulous oral cleaning decreased the risk of developing it |
B |
2B |
Berry et al.(19)
|
To test two oral hygiene strategies on the effects of microbial colonization of the dental plaque with respiratory pathogens (primary result) and incidence of pneumonia associated with mechanical ventilation (secondary outcome) |
RCT double-blind |
225/Mixed ICU |
Group B corresponded to sodium bicarbonate Group C corresponded to 0.2% CHX two times a day and irrigation with sterile water* |
Group A corresponded to sterile water |
There was no significant difference between the groups |
B |
2C |
Özçaka et al.(20)
|
To evaluate if oral scraping with 0.2% CHX decreases the risk of MVAP in patients in the ICU |
RCT double-blind |
66/Respiratory ICU |
0.2% CHX solution |
Saline solution |
The development rate of pneumonia in the control group was greater than in the study group |
B |
2B |
Koeman et al.(21)
|
To determine the effect of decontamination of the oral cavity with CHX or CHX + colistin on the incidence of MVAP |
RCT double-blind |
257/Mixed ICU |
2% CHX (1) CHX + colistin (2) |
Placebo |
Topical decontamination with CHX or CHX + colistin reduces the incidence of MVAP |
B |
2B |