Chlorhexidine and prevention of ventilator-associated pneumonia: An integrative review of VAP incidence and mortality

Abstract

Ventilator-Associated Pneumonia (VAP) is a common infection in Intensive Care Units (ICUs), with high mortality rates. Maintaining adequate oral hygiene plays a crucial role in prevention, and chlorhexidine is the main substance used for this purpose. However, uncertainties persist regarding the effective use of this substance. Objectives: This study aims to evaluate the comparative effectiveness of chlorhexidine and inert substances in preventing VAP and mortality in patients under mechanical ventilation. Methodology: The search on Pubmed, from 2013 to 2023, resulted in 194 articles, and the manual 182, with 12 articles selected for inclusion in the integrative review. The Test Group (chlorhexidine) had 779 patients, the Control Group (inert substances) involved 302 patients. The comparative analysis focused on the incidence of VAP and mortality rate. Results: In the Test Group, 19.78% developed VAP, with a mortality rate of 8.22%. In the Control Group, the incidence of VAP was 18.54%, with a mortality rate of 8.61%. Conclusion: Despite the lack of conclusiveness in this study, the widespread use of chlorhexidine in all patients does not seem to be justified, as it did not show improvements in the incidence of VAP, although it also did not result in an increase in the mortality rate.

DOI:https://doi.org/10.56238/sevened2024.003-068