Oral Care for Intensive Care Unit Patients Without Mechanical Ventilation: Protocol for a Systematic Review and Meta-Analysis
Abstract BackgroundInfection is a common problem and a major cause of morbidity and mortality for patients in intensive care units (ICUs). Oral care has been found to reduce the risk of nosocomial pneumonia according to published meta-analysis, and has been recommended to improve the oral environment for the patients in ICUs. However, relatively little information is available about the effects of oral care in patients without ventilatory support in ICUs. Therefore, this study was designed to evaluate the effectiveness of oral care in preventing pneumonia in non-ventilated ICUs patients.MethodsThe literature source will be gained from eight databases including four Chinese online databases and four English online databases from their inception to December 31, 2020. Records obtained will be managed and screened via Endnote X7,a widely used reference management software. The duplicate literature will be removed. All literature will be selected in accordance with pre-established inclusion criteria by two independent review authors to obtain quality trials. The quality of the included records will be evaluated according to “Risk of table”, recommended by Cochrane Handbook for Systematic Reviews of Interventions. All the data will be extracted by one author and checked by another. If there is any disagreement, a final agreement will be reached with a third reviewer via consulting. The data obtained will be managed via Microsoft Excel. If there is missing data, the original authors will be emailed to ask for it. If enough data was collected, the data synthesis will be performed using Review Manager (RevMan5.3). Otherwise, only the qualitative analysis will be carried out. The overall effect will be estimated on oral care for intensive care unit patients without mechanical ventilation to prevent nosocomial pneumonia using random effect model or fixed effect model base on the heterogeneity results. The sources of heterogeneity will be performed using Meta-regression and subgroup analysis if there is significant heterogeneity. The funnel plot will be used to assess the publish bias, if there are enough records included. The Cochrane Handbook for Systematic Reviews of Interventions will be followed throughout the system evaluation process.ConclusionThis study will provide evidence of oral care for intensive care unit patients without mechanical ventilation to prevent nosocomial pneumonia.PROSPERO Research registration identifying numberCRD42020146932