Safety and efficacy of oral care for intubated neuroscience intensive care unit patients.
type: CreativeWork
description: The overall aim of this research was to investigate the safety of oral care in terms of intracranial dynamics and changes in oral health during intubation and 48 hours after extubation among neuroscience intensive care unit (NICU) patients. Additional aims included comparison of a comprehensive oral care protocol (i.e., tongue scraping, electric toothbrush, non-foaming toothpaste, and application of oral moisturizers) to a standard protocol (pediatric manual toothbrush, standard toothpaste, lubricant) with respect to safety and efficacy to promote oral health and to reduce the incidence of oral nosocomial bacteria and ventilator-associated pneumonia (VAP) in NICU patients. First, a 12-month prospective cohort study with data from 45 intubated patients in an NICU was conducted to identify changes in oral health during intubation until 48 hours after extubation. Specifically, changes in oral health, intracranial pressure (ICP) recorded during non-specified oral care, the prevalence of oral nosocomial bacteria, and the incidence of VAP were analyzed. The results from the cohort study (Paper I) reflected significant deterioration in oral health during intubation and improved oral health 48 hours after extubation, as measured by the Oral Assessment Guide (OAG). During unspecified oral care methods, normal ICP recordings remained stable while ICP values greater than 20 mm Hg before oral care decreased after care (p<0.001). Progressive colonization of oral nosocomial bacteria was documented during intubation, and the overall rate of VAP was 24%. Based on literature and the results of the cohort study (Paper I), it was then hypothesized that a comprehensive oral care protocol would be safely tolerated by NICU patients, oral health would improve, and a decrease in oral nosocomial bacteria and the frequency of VAP compared to NICU patients receiving standard oral care would be observed. A two-year randomized controlled trial (RCT) was therefore conducted to compare the outcom…
abstract: The overall aim of this research was to investigate the safety of oral care in terms of intracranial dynamics and changes in oral health during intubation and 48 hours after extubation among neuroscience intensive care unit (NICU) patients. Additional aims included comparison of a comprehensive oral care protocol (i.e., tongue scraping, electric toothbrush, non-foaming toothpaste, and application of oral moisturizers) to a standard protocol (pediatric manual toothbrush, standard toothpaste, lubricant) with respect to safety and efficacy to promote oral health and to reduce the incidence of oral nosocomial bacteria and ventilator-associated pneumonia (VAP) in NICU patients. First, a 12-month prospective cohort study with data from 45 intubated patients in an NICU was conducted to identify changes in oral health during intubation until 48 hours after extubation. Specifically, changes in oral health, intracranial pressure (ICP) recorded during non-specified oral care, the prevalence of oral nosocomial bacteria, and the incidence of VAP were analyzed. The results from the cohort study (Paper I) reflected significant deterioration in oral health during intubation and improved oral health 48 hours after extubation, as measured by the Oral Assessment Guide (OAG). During unspecified oral care methods, normal ICP recordings remained stable while ICP values greater than 20 mm Hg before oral care decreased after care (p<0.001). Progressive colonization of oral nosocomial bacteria was documented during intubation, and the overall rate of VAP was 24%. Based on literature and the results of the cohort study (Paper I), it was then hypothesized that a comprehensive oral care protocol would be safely tolerated by NICU patients, oral health would improve, and a decrease in oral nosocomial bacteria and the frequency of VAP compared to NICU patients receiving standard oral care would be observed. A two-year randomized controlled trial (RCT) was therefore conducted to compare the outcom…
author: Prendergast, Virginia
language: eng
keywords: Health Sciences, Oral hygiene, Tooth Brushing, RCT, Nursing Care, Critical Care
date published: 2012
date modified: 2026-07-24T02:59:49Z
provider: University of Lund
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Health Sciences, Lund University