The Effect of Preoperative Oral Chlorhexidine Rinse on Ventilator Associated Pneumonia and ICU Mortality After Open Heart Surgery

Abstract

Objective: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU). VAP develops 10-20% of patients in 48 hours of mechanical ventilation. In this study, it was aimed to determine the effect of preoperative oral chlorhexidine rinse on VAP and mortality in patients undergoing open cardiac surgery. Methods: 300 patients who were planned to undergo elective open cardiac surgery were included in this study. Patients were prospectively randomized into two groups by a computer software. Group 1: Patients brushing their teeth and then gargling with 0.12% chlorhexidine before bedtime at the last night before surgery and 15 minutes before going to the operating room. Group 2, It consisted of patients only brushing their teeth. Results: VAP was seen in 3 patients (2.12%) in Group 1 and in 12 (8.10%) patients in Group 2 (p<0.02). Duration of intubation was 15±7.40 hours for Group 1 and 23 32.01 for Group 2. These differences were statistically significant (p <0.01). Although duration of ICU stay and hospital stay in Group 1 are shorter than in Group 2 but it was not statistically significant (p>0.05). There was no difference in mortality (p>0.05). Conclusion: Consequently, chlorhexidine gluconate rinse before elective cardiac surgery reduced the VAP rate and duration of intubation but did not change the mortality rate and the length of ICU and hospital stay. On the other hand we think these results would be change in large multicentric studies.