The Impact of Chlorhexidine Mucoadhesive Gel in the Prevention of Ventilator-Associated Pneumonia: A Randomized Clinical Trial.

Abstract

Ventilator-associated pneumonia is the common cause of morbidity and mortality in the intensive care unit. Due to the antimicrobial effect of chlorhexidine, and the long-lasting result of mucoadhesive drugs, this study aimed to determine the effect of chlorhexidine mucoadhesive gel on the prevention of ventilator-associated pneumonia in critical patients. In this clinical trial, 64 ventilated patients were selected and randomly allocated into two groups. The first group received 0.2% chlorhexidine mucoadhesive gel and the second group received 0.2% chlorhexidine solution as a mouthwash. Every three days, the incidence of ventilator-associated pneumonia was evaluated by the clinical score of pulmonary infection. The data were analyzed by SPSS statistical software version 20. There was no statistically significant difference in demographic characteristics between the two groups. In the control group, 25% of the patients had ventilator-associated pneumonia, while it was only 15.6% in the intervention group; however, the incidence of ventilator-associated pneumonia revealed no significant difference between the two groups (HR ratio, 0.86; 95% confidence interval, 0.49 to 1.83 p =0.356).In addition, there was no statistically significant difference between the number of days connected to the ventilator (p =0.854), the number of days hospitalized in the intensive care unit (p =0.423), and the death rate (p =0.634) between the two groups. Although no significant statistical difference was detected between chlorhexidine mucoadhesive gel and chlorhexidine solution in the prevention of ventilator-associated pneumonia, the incidence of pneumonia in the mucoadhesive gel group was clinically less than in the control group. It is better to repeat the study with a larger statistical population.