Prevention of Ventilator Associated Pneumonia With Toothbrushing in Oral Care of Critically Ill Mechanically Ventilated Patients

University Hospital, Clermont-Ferrand2,030 enrolled

Overview

Effect of toothbrushing in oral care of mechanically ventilated critically ill patients on prevention of ventilator associated pneumonia

Prospective, before and after study in 5 Intensive Care Units (ICUs) of a university hospital. The before period (control phase, 6 months): standard oral care 3 times a day in every consecutive intubated patients in the participating ICUs The interphase period (1 month): formal training of all the nurses, physicians and residents on the use of toothbrushing during oral care The after period: (study phase, 6 months): standard oral care with tooth brushing 3 times a day in every consecutive intubated patients in the participating ICUs

Study Type

OBSERVATIONAL

Enrollment

2,030

Conditions

Critical Care Mechanical Ventilation Ventilator Associated Pneumonia Prevention Toothbrushing Oral Care

Interventions

ToothbrushingOTHER

Toothbrushing associated with standard oral care in mechanically ventilated patients

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients * Intubated mechanically ventilated ICU patient * Platelets count \>50G/L Exclusion Criteria: * Edentulous patients

Locations (1)

CHU Clermont-Ferrand

Clermont-Ferrand, France

Outcomes

Primary Outcomes

Nosocomial ventilator associated pneumonia

Presence of at least two signs (body fever greater than 38°C; leukocytosis greater than 12000/ml or leukopenia below 4000/ml, purulent pulmonary secretions) associated with the appearance of a new infiltrate or modification of an existing infiltrate on chest-X-ray. Confirmation by a lower respiratory tract sample using a quantitative culture with a predefined positive threshold. Hospital-acquired pneumonia was defined as a pneumonia that occurs at least 48 hours after admission, which was not incubating at time of admission (Am J Respir Crit Care Med 2005; 171, 388-416).

Time frame: at Day-28

Secondary Outcomes

Tracheobronchitis

Association of at least two signs (fever above 38.0°C, Leucocytosis above 12000/ml or purulent pulmonary secretions) with isolation of bacteria in a lower respiratory tract sample without modification of chest-X-Ray.

Time frame: at Day-28

ICU length of stay

Time frame: at Day-90

ICU mortality

Time frame: at Day-90

Hospital mortality

Time frame: at Day-90

Antibiotic free days

Time frame: at Day-90

Data from ClinicalTrials.gov

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