Bulletin of Emergency and Trauma (Jan 2023)
The Impact of Chlorhexidine Mucoadhesive Gel in the Prevention of Ventilator-Associated Pneumonia: A Randomized Clinical Trial
Abstract
Objective: Ventilator-associated pneumonia is the common cause of morbidity and mortality in the intensivecare unit. Due to the antimicrobial effect of chlorhexidine, and the long-lasting result of mucoadhesive drugs,this study aimed to determine the effect of chlorhexidine mucoadhesive gel on the prevention of ventilatorassociatedpneumonia in critical patients.Method: In this clinical trial, 64 ventilated patients were selected and randomly allocated into two groups. Thefirst group received 0.2% chlorhexidine mucoadhesive gel and the second group received 0.2% chlorhexidinesolution as a mouthwash. Every three days, the incidence of ventilator-associated pneumonia was evaluatedby the clinical score of pulmonary infection. The data were analyzed by SPSS statistical software version 20.Results: There was no statistically significant difference in demographic characteristics between the twogroups. In the control group, 25% of the patients had ventilator-associated pneumonia, while it was only 15.6%in the intervention group; however, the incidence of ventilator-associated pneumonia revealed no significantdifference between the two groups (HR ratio, 0.86; 95% confidence interval, 0.49 to 1.83 p=0.356).In addition,there was no statistically significant difference between the number of days connected to the ventilator(p=0.854), the number of days hospitalized in the intensive care unit (p=0.423), and the death rate (p=0.634)between the two groups.Conclusion: Although no significant statistical difference was detected between chlorhexidine mucoadhesivegel and chlorhexidine solution in the prevention of ventilator-associated pneumonia, the incidence of pneumoniain the mucoadhesive gel group was clinically less than in the control group. It is better to repeat the study witha larger statistical population.
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