Comparison Of Oropharyngeal Apusan Culture Results In Patients Using Ventilator After 24 Hours Which Receives 0.2% Chlorhexidine Oral Decontamination And Listerin In The Intensive Care Unit Of Adam Malik Hajj Hospital Medan
Comparison of Oropharyngeal Apusan Cultural Results in Patients Using Ventilator After 24 Hours with 0.2% Chlorhexidine Oral Decontamination and Listerin in the Intensive Care Unit of Adam Malik Hajj Hospital Medan
Introduction
Maintaining oral hygiene in patients who use ventilators is crucial in medical practice, especially in the intensive care unit (ICU). The use of ventilators can lead to the accumulation of bacteria in the oropharynx, which can cause infections and increase the risk of mortality. This study aims to compare the effectiveness of chlorhexidine 0.2% and listerin as oral decontamination agents in reducing the number of bacteria in the patient's oropharynx. The study was conducted at Adam Malik Medan Hajj Hospital and involved 32 patients aged over 18 years who used ventilators with oral intubation and had a clinical pulmonary infection score (CPIS) of less than 6.
The Importance of Oral Hygiene in ICU Patients
Oral hygiene is a critical aspect of patient care in the ICU, as it can help prevent infections and promote healing. The use of ventilators can lead to the accumulation of bacteria in the oropharynx, which can cause infections such as ventilator-associated pneumonia (VAP). VAP is a common complication in ICU patients and can increase the risk of mortality. Therefore, maintaining oral hygiene is essential in preventing VAP and promoting patient safety.
Research Methods
This study uses a double-blind randomized clinical trial design. A total of 32 patients were divided into two groups, each consisting of 16 people. The first group was given 30 ml of listerin every 12 hours for 24 hours, while the second group was given 0.2% chlorhexidine with the same dose and time. After 24 hours, sampling was done on oropharyngeal swabs in the area of the lateral oropharyngeal mucosa near the tonsils using sterile swab sticks. The specimen was then sent to the microbiology laboratory to be analyzed for the sensitivity of antibiotics and bacterial culture.
Research Results
The results showed that in groups using chlorhexidine 0.2%, there were 3 patients (18.8%) who showed the growth of positive bacteria. Meanwhile, in groups that used listerin, there were 11 patients (68.8%) with positive oropharyngeal swab culture results. Analysis using the Chi-Square test showed a significant difference between the two groups in terms of bacterial growth. From the results of the Orofaring Swab culture, patients who used listerin had a risk of 3,667 times greater to experience bacterial growth compared to patients who used chlorhexidine 0.2%.
Conclusion
Based on the results of the study, chlorhexidine 0.2% proved more effective than listerin as an oral decontamination in inhibiting the growth of bacteria in the oropharynx in the first 24 hours. These findings highlight the importance of the selection of appropriate decontamination agents for patients in the ICU, in order to reduce the risk of infection and increase the prognosis of patients who use ventilators.
Additional Analysis
The selection of effective oral decontamination agents is very important, especially in patients with critical conditions. Chlorhexidine is known to have strong antimicrobial properties and has long been used in clinical practice, especially to maintain oral hygiene and prevent nosocomial infections. On the other hand, listerin, although widely used as an antiseptic, may be less effective in killing pathogenic bacteria in the oropharynx.
This difference in results can be caused by the formulation and mechanism of action of the two agents. Chlorhexidine is able to provide an antibacterial effect that lasts longer and is more effective on various types of bacteria than listerin. Therefore, the results of this study can be a basis for making decisions regarding the patient care protocol in the ICU, especially those using ventilators.
Implications for Clinical Practice
By using chlorhexidine 0.2%, medical personnel can reduce the incidence of infection and improve the quality of critical patient care, as well as reduce the cost of treatment related to infection. The implementation of these findings into clinical practice is expected to improve patient safety and overall health results in the intensive care unit.
Limitations of the Study
This study has several limitations. The sample size was relatively small, and the study was conducted in a single hospital. Therefore, the results may not be generalizable to other hospitals or populations. Additionally, the study only compared the effectiveness of chlorhexidine 0.2% and listerin, and did not evaluate other oral decontamination agents.
Future Directions
Future studies should aim to evaluate the effectiveness of other oral decontamination agents, such as povidone-iodine and hydrogen peroxide. Additionally, studies should investigate the optimal duration and frequency of oral decontamination in ICU patients. By conducting further research, healthcare providers can develop evidence-based guidelines for oral decontamination in ICU patients and improve patient outcomes.
Conclusion
In conclusion, this study demonstrated that chlorhexidine 0.2% is more effective than listerin in reducing the number of bacteria in the oropharynx in ICU patients who use ventilators. These findings highlight the importance of selecting appropriate decontamination agents for patients in the ICU and can inform clinical practice guidelines for oral decontamination in ICU patients.
Frequently Asked Questions (FAQs) about Oropharyngeal Apusan Cultural Results in Patients Using Ventilator After 24 Hours with 0.2% Chlorhexidine Oral Decontamination and Listerin in the Intensive Care Unit of Adam Malik Hajj Hospital Medan
Q: What is the purpose of this study?
A: The purpose of this study is to compare the effectiveness of chlorhexidine 0.2% and listerin as oral decontamination agents in reducing the number of bacteria in the patient's oropharynx in ICU patients who use ventilators.
Q: What is oropharyngeal apusan culture?
A: Oropharyngeal apusan culture is a type of culture that is used to detect the presence of bacteria in the oropharynx. It involves taking a swab sample from the oropharynx and sending it to the laboratory for analysis.
Q: What is the significance of this study?
A: This study is significant because it highlights the importance of selecting appropriate decontamination agents for patients in the ICU. The results of this study can inform clinical practice guidelines for oral decontamination in ICU patients and improve patient outcomes.
Q: What are the limitations of this study?
A: The limitations of this study include a small sample size and the fact that it was conducted in a single hospital. Therefore, the results may not be generalizable to other hospitals or populations.
Q: What are the implications of this study for clinical practice?
A: The implications of this study for clinical practice are that chlorhexidine 0.2% is a more effective oral decontamination agent than listerin in reducing the number of bacteria in the oropharynx in ICU patients who use ventilators. This can inform clinical practice guidelines for oral decontamination in ICU patients and improve patient outcomes.
Q: What are the potential risks and benefits of using chlorhexidine 0.2% as an oral decontamination agent?
A: The potential benefits of using chlorhexidine 0.2% as an oral decontamination agent include reducing the incidence of infection and improving the quality of critical patient care. The potential risks include the possibility of allergic reactions or other adverse effects.
Q: What are the potential risks and benefits of using listerin as an oral decontamination agent?
A: The potential benefits of using listerin as an oral decontamination agent include its wide availability and low cost. The potential risks include the possibility of listerin being less effective in killing pathogenic bacteria in the oropharynx.
Q: What are the future directions for research in this area?
A: Future research should aim to evaluate the effectiveness of other oral decontamination agents, such as povidone-iodine and hydrogen peroxide. Additionally, studies should investigate the optimal duration and frequency of oral decontamination in ICU patients.
Q: How can healthcare providers apply the findings of this study to their practice?
A: Healthcare providers can apply the findings of this study by selecting chlorhexidine 0.2% as the oral decontamination agent of choice for ICU patients who use ventilators. They should also consider the optimal duration and frequency of oral decontamination in these patients.
Q: What are the implications of this study for patient safety and quality of care?
A: The implications of this study for patient safety and quality of care are that the use of chlorhexidine 0.2% as an oral decontamination agent can reduce the incidence of infection and improve the quality of critical patient care. This can lead to improved patient outcomes and reduced healthcare costs.