Appendix F: VAP Prevention – Oral care with Chlorhexidine (CHG) Things you should know! Regular oral care with CHG is associated with decreased colonization of dental plaque, and a decreased incidence of ventilator-associated pneumonia (VAP). Guidelines for VAP prevention, published before 2008, do not address the use of CHG for oral care. Increasing evidence to support this intervention has emerged over the past several years. In 2011, a systematic review and meta-analysis of 12 randomized trials supported the use of oral care with CHG for VAP prevention. Overall, this study found a 38% VAP reduction. Favorable effects were more pronounced in cardiosurgical studies (up to a 59% VAP reduction). guidelines below were written, 11 other peer reviewed publications have been written supporting the effectiveness of the use of CHG for oral care in the prevention of VAP Perform regular oral care with an antiseptic solution in accordance with product guidelines. 2008-Society for Healthcare Epidemiology of America Did not specify CHG. A guideline of practical recommendations to assist acute All studies demonstrated the effectiveness of oral care with CHG, specifically in the cardiac care hospitals in implementing and prioritizing their ventilator-associated pneumonia (VAP) prevention surgery population. efforts. The use of the oral antiseptic chlorhexidine should be considered. Based on 1 level 1 and 2 level 2 trials, the use of the oral antiseptic CHG may decrease the 2004-Canadian VAP Prevention Guidelines: incidence of VAP. Safety, feasibility, and cost clinical practice guidelines for the prevention of considerations for this intervention are all very ventilator-associated pneumonia. favorable. Recommends regular oral care. States that chlorhexidine has prevented hospital-acquired pneumonia in specific populations such as those 2004-Guidelines for the Management of adults with undergoing coronary bypass grafting, However, Hospital-acquired, Ventilator-associated, and also states that routine use is not recommended Pneumonia. until more data is available. No recommendation can be made for the routine use of an oral chlorhexidine rinse for the 2003-CDC Guidelines for preventing prevention of healthcare–associated pneumonia Pneumonia in all postoperative or critically ill patients and/or other patients at high risk for pneumonia
Appendix F: VAP Prevention – Oral care with Chlorhexidine (CHG) Things you should know! Regular oral care with CHG is associated with decreased colonization of dental plaque, and a decreased incidence of ventilator-associated pneumonia (VAP). Guidelines for VAP prevention, published before 2008, do not address the use of CHG for oral care. Increasing evidence to support this intervention has emerged over the past several years. In 2011, a systematic review and meta-analysis of 12 randomized trials supported the use of oral care with CHG for VAP prevention. Overall, this study found a 38% VAP reduction. Favorable effects were more pronounced in cardiosurgical studies (up to a 59% VAP reduction). guidelines below were written, 11 other peer reviewed publications have been written supporting the effectiveness of the use of CHG for oral care in the prevention of VAP 2008-Society for Healthcare Epidemiology of America A guideline of practical recommendations to assist acute care hospitals in implementing and prioritizing their ventilator-associated pneumonia (VAP) prevention efforts. Perform regular oral care with an antiseptic solution in accordance with product guidelines. Did not specify CHG. All studies demonstrated the effectiveness of oral care with CHG, specifically in the cardiac surgery population. 2004-Canadian VAP Prevention Guidelines: clinical practice guidelines for the prevention of ventilator-associated pneumonia. The use of the oral antiseptic chlorhexidine should be considered. Based on 1 level 1 and 2 level 2 trials, the use of the oral antiseptic CHG may decrease the incidence of VAP. Safety, feasibility, and cost considerations for this intervention are all very favorable. 2004-Guidelines for the Management of adults with Hospital-acquired, Ventilator-associated, and Pneumonia. Recommends regular oral care. States that chlorhexidine has prevented hospital-acquired pneumonia in specific populations such as those undergoing coronary bypass grafting, However, also states that routine use is not recommended until more data is available. 2003-CDC Guidelines for preventing Pneumonia No recommendation can be made for the routine use of an oral chlorhexidine rinse for the prevention of healthcare–associated pneumonia in all postoperative or critically ill patients and/or other patients at high risk for pneumonia
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