Prevention of ventilator-associated pneumonia by a nose care program combining with oral care among patients hospitalized in intensive care units: a single-blind randomized controlled trial

Prevención de la neumonía asociada al ventilador mediante un programa de cuidado de la nariz combinado con el cuidado bucal en pacientes hospitalizados en unidades de cuidados intensivos: un ensayo controlado aleatorio simple ciego

Objective

Ventilator-associated pneumonia (VAP) is one of the most common ICU-acquired infections. Preventing nasal canal colonization through an effective nasal cavity care, along with oral care seem to be an important issue.

Methods

This single-blind randomized controlled trial was conducted on 31 patients in each intervention and control group in Alzahra and Kashani hospitals, Iran. The interventional program was considered every 8 h for 5 days. It included cleaning the nasal cavities with cotton swabs soaked in sterile normal saline, then 2 puffs of 65% sodium chloride nasal spray were used for each nostril, and finally the nasal canal was moistened with a swab dipped in Veramin gel (0.5 ml into each nostril). For the control group, routine nasal care including cleaning the outer nostrils was offered. Oral care in 2 groups was performed according to the standard protocol. Data collected through demographic and clinical questionnaire as well as modified pulmonary infection clinical scale. The chi-square and independent tests were used to determine the homogeneity of basic characteristics. Also, we estimated and compared the incidence of VAP between 2 groups by chi-square test.

Results

The incidence of VAP was not statistically different in the intervention and control groups on the third day after intervention (29.1% vs. 32.3%, respectively, P = .915), while this rate on the sixth day was significantly lesser in the intervention than control (32.3 vs. 58%, P = .041).

Conclusion

The present nasal care program along with oral care is an effective strategy to prevent VAP.

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