Oral Care of Intubated Patients

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Receiving care in an intensive care unit (ICU) can greatly influence patients’ survival and quality of life. The benefit achieved in terms of improved survival rates is particularly attributed to the favorable changes in supportive care made over the past decades. The improved acute phase survival, however, was associated with a growing number of long-term ICU residents at high risk for infection, especially when orally intubated. Today, one of the most dreaded complications associated with endotracheal intubation is ventilator-associated pneumonia. Bad oral health and microaspiration of subglottic secretions and debris are pivotal in the pathogenesis of this harmful complication. Good oral hygiene is a key issue in preventing dental plaque formation and microbial growth in the mouth. However, evidence-based recommendations for oral care are not available. Therefore, substantial efforts aiming to provide this information are urgently needed, as well as training and motivation of all health care workers involved in the care of intubated patients. In the meantime, providing adequate chemical (ie, use of chlorhexidine or povidone-iodine solutions) as well as mechanical (ie, manual or electric toothbrush, and subglottic aspiration) oral care is considered suitable because both approaches may be the main contributing factors to decrease the risk of respiratory infections.

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