Effect of Oropharyngeal Decontamination by Dekasan for the Prevention of Ventilator-Associated Pneumonia in Critically Ill Patients

А.V. Tsarev

Abstract


The main cause of ventilator-associated pneumonia (VAP) is the translocation of bacteria colonizing the oral cavity. The aim of the study was the use of oropharyngeal antiseptic Dekasan for the prevention of VAP in patients with head injury, polytrauma and mine blast trauma injuries being on prolonged mechanical ventilation. Materials and methods. A total of 50 critically ill patients were on mechanical ventilation for ≥ 5 days. Patients were divided into two groups: Group 1 (n = 25) was the arm for oropharyngeal decontamination by oropharyngeal rinsing with dekasan 20 ml («Yuri-Farm», Ukraine) at least 3 times/day; group 2 (control) (n = 25) included the patients with oropharyngeal rinsing with 50 ml of 0.9% NaCl at least 3 times/day. We used the clinical criteria of VAP, as well as the scale of the development of pulmonary infection — CPIS and the Lungs Injury Scale — LIS. Results. Average CPIS scale va­lue was significantly lower in the group has been using dekasan (6.4 ± 1.3 points) compared to the control group (7.8 ± 1.5 points). The LIS found no significant difference between the study groups (in the first group — 10.7 ± 2.9 points, in the se­cond — 11.8 ± 2.4 points). In the group with oropharyngeal decontamination by dekasan rate of VAP was 40 %, in the group of 0.9% NaCl — 72 %. Conclusions. Regular dental debridement with the aim of oropharyngeal decontamination by dekasan can be an effective strategy to reduce the level of development of VAP in crirically ill patients being on extended mechanical ventilation.


Keywords


dekasan; ventilator-associated pneumonia; oropharyngeal deconotamination; intensive care

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DOI: https://doi.org/10.22141/2224-0586.5.76.2016.76435

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