TY - JOUR T1 - EFFECT OF ORAL HYGIENE AND 0.12% CHLORHEXIDINE GLUCONATE ORAL RINSE IN PREVENTING OF VENTILATOR-ASSOCIATED PNEUMONIA AFTER CARDIOVASCULAR SURGERY JF - Respiratory Care DO - 10.4187/respcare.02666 SP - respcare.02666 AU - Liliana Noemí Nicolosi AU - Maria del Carmen Rubio AU - Carlos Daniel Martinez AU - Nidia Noemí González AU - Marisa Edith Cruz Y1 - 2013/10/08 UR - http://rc.rcjournal.com/content/early/2013/10/08/respcare.02666.abstract N2 - Ventilator-associated pneumonia is a nosocomial infection of multifactorial etiology and has a negative influence on cardiovascular surgery outcomes. OBJECTIVES: To determine the effect of tooth-brushing plus 0.12% chlorhexidine gluconate oral rinse in preventing of ventilator-associated pneumonia after cardiovascular surgery. METHODS: In a quasi-experimental study patients undergoing heart surgery were enrolled on a protocol for controlling dental biofilm by proper oral hygiene (tooth brushing) and oral rinses with 0.12% chlorhexidine gluconate (Group 1), and were compared to a group of historical controls (Group 2), which included patients who underwent cardiac surgery between 2009 and 2010 and who received regular oral hygiene care. Seventy-two hours before surgery, a dentist instructed and supervised oral hygiene with tooth brushing and chlorhexidine oral rinses in patients in Group 1. RESULTS: Each group comprised 150 patients. A lower incidence of ventilatorassociated pneumonia (2.66%; 95% CI = 0.71-7.8 vs. 8.66%; 95% CI= 4.88- 14.66; p=0.04), and shorter hospital stay (measured in days) (9 ± 3; 95% CI = 8.51-9.48 vs. 10 ± 4; 95% CI= 9.35-10.64; p=0.01) were observed in Group 1. No significant differences in all-cause in-hospital death were observed between groups (5.33% vs. 4.66%; p=1.00). The risk for developing pneumonia after surgery was three-fold higher in Group 2 (OR 3.87; 95% CI =1.05-14.19). CONCLUSIONS: Oral hygiene and mouth rinses with chlorhexidine under supervision of a dentist proved effective in reducing the incidence of ventilator-associated pneumonia. ER -