Oral Care in Critically Ill Infants and the Potential Effect on Infant Health: An Integrative Review.

IF 2 4区 医学 Q3 CRITICAL CARE MEDICINE
Leslie A Parker, Jennifer Pruitt, Angela Monk, Monica Torrez Lambert, Graciela L Lorca, Josef Neu
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引用次数: 1

Abstract

Background: Critically ill infants admitted to the neonatal intensive care unit are at risk for ventilator-associated pneumonia and abnormal oral colonization. Adherence to evidence-based guidelines for oral care in critically ill adults is associated with improved short- and long-term health outcomes. However, oral care guidelines for critically ill infants admitted to the neonatal intensive care unit have not been established, possibly increasing their risk of ventilator-associated pneumonia and other health complications.

Objective: To describe and summarize the evidence regarding oral care for critically ill infants admitted to the neonatal intensive care unit and to identify gaps needing further investigation.

Methods: The MEDLINE (through PubMed) and CINAHL databases were searched for observational studies and randomized controlled trials investigating the effect of oral care on oral colonization, ventilator-associated pneumonia, and health outcomes of infants in the neonatal intensive care unit.

Results: This review of 5 studies yielded evidence that oral care may promote a more commensal oral and endotracheal tube aspirate microbiome. It may also reduce the risk of ventilator-associated pneumonia and length of stay in the neonatal intensive care unit. However, the paucity of research regarding oral care in this population and differences in oral care procedures, elements used, and timing greatly limit any possible conclusions.

Conclusions: Oral care in critically ill infants may be especially important because of their suppressed immunity and physiological immaturity. Further appropriately powered studies that control for potential covariates, monitor for adverse events, and use recommended definitions of ventilator-associated pneumonia are needed to make clinical recommendations.

危重婴儿口腔护理及其对婴儿健康的潜在影响:一项综合综述。
背景:入住新生儿重症监护病房的危重婴儿存在呼吸机相关肺炎和异常口腔定植的风险。在危重症成人中遵守循证口腔护理指南与改善短期和长期健康结果相关。然而,对于入住新生儿重症监护病房的危重婴儿的口腔护理指南尚未建立,这可能会增加他们患呼吸机相关肺炎和其他健康并发症的风险。目的:描述和总结新生儿重症监护室危重婴儿口腔护理的证据,并确定需要进一步调查的差距。方法:通过MEDLINE(通过PubMed)和CINAHL数据库检索观察性研究和随机对照试验,调查口腔护理对新生儿重症监护病房中口腔定植、呼吸机相关肺炎和婴儿健康结局的影响。结果:本综述对5项研究进行了回顾,结果表明口腔护理可以促进口腔和气管内吸入微生物群的更多共生。它还可以减少呼吸机相关肺炎的风险和新生儿重症监护病房的住院时间。然而,关于这一人群口腔护理的研究的缺乏以及口腔护理程序、使用的要素和时间的差异极大地限制了任何可能的结论。结论:危重婴儿由于免疫功能低下和生理发育不成熟,口腔护理尤为重要。需要进一步的适当的研究来控制潜在的协变量,监测不良事件,并使用推荐的呼吸机相关性肺炎的定义来提出临床建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Critical care nurse
Critical care nurse 医学-护理
CiteScore
2.80
自引率
0.00%
发文量
68
审稿时长
>12 weeks
期刊介绍: Critical Care Nurse (CCN) is an official publication of the American Association of Critical-Care Nurses (AACN). Authors are invited to submit manuscripts for consideration and peer review. Clinical topics must meet the mission of CCN and address nursing practice of acute and critically ill patients.
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