Oral Hygiene in Ventilated Patients (ICU)

Running head: 1 ORAL HYGIENE IN VENTILATED PATIENTS (ICU)
Oral Hygiene in Ventilated Patients (ICU)
Name
Institution

ORAL HYGIENE IN VENTILATED PATIENTS (ICU)
Oral Hygiene in Ventilated Patients (ICU)
Introduction
VAP is a subcategory of clinic-received pneumonia, which affects sick people under MV
by way of a tracheostomy or endotracheal tube for at minimum forty-eight to seventy-two hours.
This form of pneumonia affects nine to twenty-seven percent of patients in the ICUs. In the
USA, the expenditure is two billion dollars yearly and nearly thirty thousand to forty thousand
dollars per case (Berry et al. 2017). The rate of mortality for VAP varies from twenty to seventy
percent. VAP intensifies the duration of hospital stay and mechanical ventilation. It is also liable
for fifty percent of the antibiotics recommended in the ICUs.
The most significant method in VAP development is the unstopping micro-aspiration of
oropharyngeal colonization into the tract of respiration that is found at a lower level. A day
following a sick person’s entry to the ICU, common oropharyngeal flora adjusts into pathogens
that are gram negative that elevate the plaque of the teeth. Plaques are conducive conditions for
the accumulation together with the growth of pathogens. Moreover, the tracheal tube may
function as a channel for the pathogens of the oral cavity to the lungs (Woodrow. 2017).
Numerous research have demonstrated a relation between respiratory pathogens and dental
plaque colonization. The occurrence of VAP is minimized through improving prevention
methods and by identifying the risk factors. Currently, the rate of mortality of VAP has been
projected at about nine to thirteen percent.
My PICO
Population: Adult population in the ICU with a mechanical ventilator.
Intervention: Oral topical decontamination

ORAL HYGIENE IN VENTILATED PATIENTS (ICU)
Comparison: No standard oral care or solution.
Outcome: Minimize ventilated related pneumonia among adult patients in the ICU with a
mechanical ventilator.
Answerable Question
Answerable question: What is the efficacy of oral rinse with 0.2 percent and 2 percent
chlorhexidine on oropharyngeal in minimizing the prevalence of ventilator related pneumonia?
The answerable question was developed by first identifying the population who are adult
patients in ICU with a mechanical ventilator. Secondly, I came up with the intervention that is to
reduce the likelihood of contracting pneumonia amongst patients at the adult stage with a
mechanical ventilator. Then thirdly, a comparison is made, which is then followed by the
outcome of the intervention. Finally, an answerable question is formulated that comprises of the
above-stated parts.
Literature
VAP carries on to cause difficulties to the rate of eight to twenty-eight percent of patients
getting mechanical ventilation (Morris et al. 2017). In divergence to infections of more often
engaged organs (for instance urinary and skin tract), in which death is little, varying from one to
four percent, the level of mortality for VAP varies from twenty-four to fifty percent and can get
to seventy-six percent when infection of lung is caused by some pathogens of high risk or in
some specific settings. The leading organisms liable for infection are Staphylococcus aureus,
Enterobacteriaceae and Pseudomonas aeruginosa, though etiologic agents extensively vary in
accordance to the patient's population in an intensive care unit, prior antimicrobial therapy, and
duration of hospital stay (Heo et al. 2018). Since suitable antimicrobial therapy of a patient with

ORAL HYGIENE IN VENTILATED PATIENTS (ICU)
VAP substantially enhances results, more accurate selection of microbial agents and rapid
identification of infected patients represent crucial clinical targets. Notwithstanding the major
developments in strategies for the supervision of sick people who rely on a ventilator and the
regular utilization of useful methods to clean respiratory tools, VAP continues to set hurdles to
the course of eight to twenty-eight percent of the patients getting mechanical ventilation (Rello et
al. 2017). Pneumonia rates are noticeably greater among hospitalized patients in the ICU
contrasted with those in wards of the hospital, together with the threat of pneumonia is
intensified by three to tenfold for the patients who are intubated and are getting mechanical
ventilation.
The current review is based on an assessment of the literature, chosen through a
computerized MEDLINE search from the year 1980 to the year 2001. Consensus statements,
review articles, and the references cited were also contemplated in this attempt to revise the
present knowledge on the analysis, epidemiology, and therapy of VAP (Jones et al. 2014). Since
the Practice for Hospital Infection, Advisory Committee of the Centers for Disease Prevention
and Regulation published up-to-date and extensive suggestions for the deterrence of nosocomial
pneumonia in 1997 and other comprehensive reviews are also available.
Correct data on VAP epidemiology are constrained by the lack of harmonized criteria for
its diagnosis. Theoretically, VAP is described as the inflammation of the lung parenchyma
instigated by agents that are infectious incubating or absent at the time the MV initiation
(Fourrier et al. 2015). Notwithstanding the clearness of this conception, the last 3 decades have
seen the advent of several definitions of operation, which none is accepted universally. In focal
areas of the lobe, pneumonia may fail to be seen, microbiologic research may be negative
notwithstanding the existence of inflammation in the lung and practitioners may differ