Efficacy of oral chlorhexidine in critical care

摘要: In their review of airway hygiene, Jelic and colleagues highlighted that colonization or infection the upper precedes development ventilator-associated pneumonia [1]. Although effects chlorhexidine on reducing were discussed, there was no mention possible contribution physical plaque removal, in particular tooth brushing, which is often performed either infrequently inadequately mechanically ventilated patients Such removal important because critically ill normal microflora dental becomes rapidly colonized by potential pathogens, this biofilm serves as a reservoir for subsequent [2,3]. Physical essential optimal benefit since its primary action inhibition formation. Whilst kills both Gram-negative bacteria Gram-positive damaging cell wall, antiplaque activity superior to other antiseptics with greater antibacterial activity. This occurs absorbed onto oral surfaces released over long period time. property, known substantivity, explains why excellent at inhibiting formation clean mouth but otherwise limited efficacy [4]. It also not generally appreciated if toothpaste used prior then it must be thoroughly removed prevent inactive low-solubility salts [5]. Oral widely critical care practice has been subject many investigations patients. These studies unfortunately do address need mechanical cleaning use therefore potentially underestimate agent pneumonia.