Prevention of ventilator-associated pneumonia by a nose care program combining with oral care among patients hospitalized in intensive care units: a single-blind randomized controlled trial

Abstract

Objective

Ventilator-associated pneumonia (VAP) is one of the most common ICU-acquired infections. Preventing nasal canal colonization through an effective nasal cavity care, along with oral care seem to be an important issue.

Methods

This single-blind randomized controlled trial was conducted on 31 patients in each intervention and control group in Alzahra and Kashani hospitals, Iran. The interventional program was considered every 8 h for 5 days. It included cleaning the nasal cavities with cotton swabs soaked in sterile normal saline, then 2 puffs of 65% sodium chloride nasal spray were used for each nostril, and finally the nasal canal was moistened with a swab dipped in Veramin gel (0.5 ml into each nostril). For the control group, routine nasal care including cleaning the outer nostrils was offered. Oral care in 2 groups was performed according to the standard protocol. Data collected through demographic and clinical questionnaire as well as modified pulmonary infection clinical scale. The chi-square and independent tests were used to determine the homogeneity of basic characteristics. Also, we estimated and compared the incidence of VAP between 2 groups by chi-square test.

Results

The incidence of VAP was not statistically different in the intervention and control groups on the third day after intervention (29.1% vs. 32.3%, respectively, P = .915), while this rate on the sixth day was significantly lesser in the intervention than control (32.3 vs. 58%, P = .041).

Conclusion

The present nasal care program along with oral care is an effective strategy to prevent VAP.