scholarly journals Oropharyngeal Decontamination for Prevention of VAP in PatientsAdmitted to Intensive Care Units: A Systematic Review

2021 ◽  
Author(s):  
Aliakbar Keykha ◽  
Monir Ramezani ◽  
Shahram Amini ◽  
Hossein Karimi Moonaghi
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Randomized Clinical Trials ◽  
Web Of Science ◽  
Cochrane Library ◽  
Ventilator Associated Pneumonia ◽  
Topical Antibiotics ◽  
Selective Oropharyngeal Decontamination ◽  
Combined Use ◽  
Prophylactic Use

AbstractIntroduction: Oropharyngeal colonization with pathogenic organisms contributes to thedevelopment of ventilator-associated pneumonia (VAP) in intensive care units (ICUs). Oralhygiene care (OHC) is a very effective method for reducing the risk of VAP in these patients.This study aimed to evaluate recent OHC strategies to decrease VAP.Methods: Randomized clinical trials (RCTs) published in the PubMed, Scopus, Embase,Cochrane Library, and Web of Science databases from inception to September 10, 2020 werereviewed to compare the effects of selective oropharyngeal decontamination (SOD) on theincidence of VAP in adult patients requiring mechanical ventilation.Results: Out of a total of 1098 articles reviewed, 17 eligible studies were included for finalanalysis. The results showed that the use of chlorhexidine for oropharyngeal decontaminationreduces the incidence of VAP. However, it had a small effect on gram-negative resistant bacteria.Also, it was observed that the combined use of colistin and chlorhexidine was more effectivethan chlorhexidine alone in preventing VAP. The results of studies on the use of toothbrushes toreduce the incidence of pneumonia are unclear since they used chlorhexidine at the same time.However, tooth brushing is one of the best ways to maintain oral hygiene. Using povidoneiodine,Nanosil, and non-absorbable topical antibiotics reduced the incidence of VAP, whileIseganan did not show a significant effect in this regard.Conclusion: The prophylactic use of topical bactericidal agents in critically-ill patients is effectivein reducing the incidence of VAP. However, the use of non-absorbable topical antibiotics ismore effective than other methods in oropharyngeal decontamination.

scholarly journals Combined use of serum (1,3)-β-d-glucan and procalcitonin for the early differential diagnosis between candidaemia and bacteraemia in intensive care units

Critical Care ◽  
2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniele Roberto Giacobbe ◽  
◽  
Malgorzata Mikulska ◽  
Mario Tumbarello ◽  
Elisa Furfaro ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Combined Use

The Role of Nutrition during the COVID-19 Pandemic: What We Know

2021 ◽  
Vol 21 ◽  
Author(s):  
Elsa Vitale ◽  
Manrico Magrone ◽  
Vito Galatola ◽  
Thea Magrone
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Immune System ◽  
General Population ◽  
Web Of Science ◽  
Cochrane Library ◽  
Nutritional Interventions ◽  
Clinical Consequences ◽  
Institutional Websites

Background: Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) (COVID-19) infection provokes serious clinical consequences, which in many situations need hospitalization of the patient in Intensive Care Unit. Additionally, SARS-COV-2 infection can indirectly cause deaths in aged individuals as well as in patients with comorbidities. Objective: To evaluate the effects of nutrition during the COVID-19 pandemic in both hospitalized patients and in the general population. Methods: Authors searched Medline (PubMed), Web of Science, EMBASE, Cochrane Library, Google, and Institutional websites for medical subheadings terms and free full text referred to “SARS-CoV-2”, COVID-19”, “nutrition”, “immune system”, before 31st July 2020. Results: A total of 20 articles describing different nutritional interventions for patients with SARS-CoV-2 infection focusing on the general population have been included. Of these, 6 studies are dealing with nutritional interventions for patients with SARS-CoV2 infection and the others are focalized on a potential beneficial effect exerted by a Mediterranean-type diet, related to the supplementation of micronutrients and vitamins. Conclusion: A correct lifestyle even including the consumption of nutrient largely present in MD, may be beneficial for preventing or improving prognosis in the SARS-CoV-2 infection.

Nurses’ Implementation of Guidelines for Ventilator-Associated Pneumonia From the Centers for Disease Control and Prevention

2007 ◽  
Vol 16 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Carolyn L. Cason ◽  
Tracy Tyner ◽  
Sue Saunders ◽  
Lisa Broome
Keyword(s):  
Intensive Care ◽  
Disease Control ◽  
Intensive Care Units ◽  
Oral Care ◽  
The United States ◽  
Hand Washing ◽  
Ventilator Associated Pneumonia ◽  
Care Protocol ◽  
Control And Prevention ◽  
Centers For Disease Control

• Background Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units. Adherence to the best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia. • Objective To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation. • Methods Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided. • Results Twelve hundred nurses completed the questionnaire. Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed elevation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols. • Conclusions The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols.

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