Prevention of ventilator-associated pneumonia in ICU patients by
Ozonated water mouthwash: a double-blind randomized clinical trial
Abstract
Background and Aims: Oral care is one of the most important treatment
programs for patients undergoing mechanical ventilation in ICU that
helps prevent nosocomial infections. The aim of this study was to
compare two mouthwash solutions: chlorhexidine and ozonated water for
prevention of ventilator-associated pneumonia (VAP) in patients
connected to mechanical ventilation in ICU. Methods: The present study
is a double-blind randomized clinical trial performed on eligible
patients in the ICU in two hospitals. The Clinical Pulmonary Infection
Score (CPIS) checklists and culture swap to examine the presence of
microorganism in the patient’s pulmonary secretions were used to
evaluate the effect of chlorhexidine mouthwash and ozonated water on
incidence of VAP. Results: The effects of both chlorhexidine mouthwash
and ozonated water on prevention of VAP varied over time (the first, the
third and the fifth days). There was also a significant difference in
the incidence of VAP in the two groups of chlorhexidine mouthwash and
ozonated water in terms of the culture of pulmonary secretions in the
two groups (P= 0.050). Incidence of VAP in the mouthwash group with
chlorhexidine, 45.9% and in the mouthwash group with ozonated water,
25% were positive. Conclusion: Ozonated water mouthwash was more
effective than chlorhexidine mouthwash in preventing VAP.