Oral hygiene practices in pediatric intensive care units: a scoping review
DOI:
https://doi.org/10.26694/reufpi.v13i1.4261Palavras-chave:
Child, Oral hygiene, Chlorhexidine, Intensive Care Units, PediatricResumo
Objective: To explore and map the literature on oral hygiene (OH) practices in pediatric patients admitted to Pediatric Intensive Care Units (PICU). Methods: The Arksey and O’Malley’s five-stage methodological framework for scoping reviews was conducted using Pubmed, Bireme, Scopus, Web of Science and Cochrane Library databases. Clinical trials reporting OH practices in PICU and published in English language were included. Non-interventional studies, case reports and studies with neonates, adolescents or adults were excluded from the review. Results: The 11 included studies indicate that OH has been integrated into protocols for the prevention of ventilator-associated pneumonia (VAP) or into prevention bundles. The most common agent used for OH in mechanically ventilated children was 0.12% chlorhexidine. There is not enough evidence to support a safe and uniform protocol for OH in children admitted to PICU. Conclusion: A gap regarding OH in non-ventilated children was found in the literature. Further studies are needed to support the development of a uniform, safe, effective and evidence-based OH protocol for children in PICU.
Referências
Safdar N, Crnich CJ, Maki DG. The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention. Respir Care. 2005 Jun;50(6):725-39
Castro Piau CGB, Azevedo TD, de Castro Piau AG, Miranda AF, Pinheiro JA, Bezerra AC. Oral Microbial Colonization in Pediatric Intensive Care Unit Patients. J Dent Child (Chic). 2016;83(2):53-9
Pinheiro CLS, Lima FP, Machado FC, Santos SS, Malheiro ARX, Ataíde LA, Figueiredo ACL. Oral and tracheal microbiota of pediatric and adolescent patients in an intensive care unit. Spec Care Dentist. 2021 Sep;41(5):599-606. doi: 10.1111/scd.12602.
Niedzwiecka T, Patton D, Walsh S, Moore Z, O'Connor T, Nugent L. What are the effects of care bundles on the incidence of ventilator-associated pneumonia in paediatric and neonatal intensive care units? A systematic review. J Spec PediatrNurs. 2019 Oct;24(4):e12264. doi: 10.1111/jspn.12264.
Johnstone L, Spence D, Koziol-McClain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. PediatrNurs. 2010 Mar-Apr;36(2):85-96
Karakaya Z, Duyu M, Yersel MN. Oral mucosal mouthwash with chlorhexidine does not reduce the incidence of ventilator-associated pneumonia in critically ill children: A randomised controlled trial. Aust Crit Care. 2022 Jul;35(4):336-44. doi: 10.1016/j.aucc.2021.06.011.
KonukSener D, Aydin M, Cangur S, Guven E. The Effect of Oral Care with Chlorhexidine, Vitamin E and Honey on Mucositis in Pediatric Intensive Care Patients: A Randomized Controlled Trial. J PediatrNurs. 2019 Mar-Apr;45:e95-e101. doi: 10.1016/j.pedn.2019.02.001
Mendes KD, Silveira RC, Galvão CM. Revisãointegrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. TextoContexto - Enferm. 2008 Dez;17(4):758-64. doi: 10.1590/S0104-07072008000400018
Torraco RJ. Writing integrative reviews of the literature: Methods and purposes. Int J Adult Voc Educ Tech. 2016 Jul;7(3):62-70.
Pedreira ML, Kusahara DM, de Carvalho WB, Núñez SC, Peterlini MA. Oral care interventions and oropharyngeal colonization in children receiving mechanical ventilation. Am J Crit Care. 2009 Jul;18(4):319-28; quiz 329. doi: 10.4037/ajcc2009121.
Jácomo AD, Carmona F, Matsuno AK, Manso PH, Carlotti AP. Effect of oral hygiene with 0.12% chlorhexidine gluconate on the incidence of nosocomial pneumonia in children undergoing cardiac surgery. Infect Control Hosp Epidemiol. 2011 Jun;32(6):591-6. doi: 10.1086/660018.
Kusahara DM, Friedlander LT, Peterlini MA, Pedreira ML. Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children. Nurs Crit Care. 2012 May-Jun;17(3):115-22. doi: 10.1111/j.1478-5153.2012.00494.x.
Kusahara DM, Peterlini MA, Pedreira ML. Oral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: randomised, controlled and double blind trial. Int J Nurs Stud. 2012 Nov;49(11):1354-63. doi: 10.1016/j.ijnurstu.2012.06.005.
Sebastian MR, Lodha R, Kapil A, Kabra SK. Oral mucosal decontamination with chlorhexidine for the prevention of ventilator-associated pneumonia in children - a randomized, controlled trial. Pediatr Crit Care Med. 2012 Sep;13(5):e305-10. doi: 10.1097/PCC.0b013e31824ea119.
Handa S, Chand S, Sarin J, Singh VA, Sharma S. Effectiveness of oral care protocol on oral health status of hospitalised children admitted in intensive care units of selected hospital of Haryana. Nurs Midwifery Res J. 2014;10, 8–15. doi: 10.33698/NRF0170.
Esteban E, Ferrer R, Urrea M, Suarez D, Rozas L, Balaguer M, Palomeque A, Jordan I. The impact of a quality improvement intervention to reduce nosocomial infections in a PICU. Pediatr Crit Care Med. 2013 Jun;14(5):525-32. doi: 10.1097/PCC.0b013e31828a87cc.
Gomaa MM, Wahba Y, El-Bayoumi MA. Pre versus post application of a 0.12% chlorhexidine based oral hygiene protocol in an Egyptian pediatric intensive care unit: Practice and effects. Egypt J Crit Care Med. 2017;5(3):87-91.doi: 10.1016/j.ejccm.2017.11.002
Rosenthal VD, Álvarez-Moreno C, Villamil-Gómez W, Singh S, Ramachandran B, Navoa-Ng JA, Dueñas L, et al. Effectiveness of a multidimensional approach to reduce ventilator-associated pneumonia in pediatric intensive care units of 5 developing countries: International Nosocomial Infection Control Consortium findings. Am J Infect Control. 2012 Aug;40(6):497-501. doi: 10.1016/j.ajic.2011.08.005.
Peña-López Y, Pujol M, Campins M, González-Antelo A, Rodrigo JÁ, Balcells J, Rello J. Implementing a care bundle approach reduces ventilator-associated pneumonia and delays ventilator-associated tracheobronchitis in children: differences according to endotracheal or tracheostomy devices. Int J Infect Dis. 2016 Nov;52:43-8. doi: 10.1016/j.ijid.2016.09.021.
The Joanna Briggs Institute. The Joanna Briggs Institute Reviewers’ Manual 2015: Methodology for JBI scoping reviews [Internet]. 2015 edition. Joanne Briggs Institute. Australia: The Joanna Briggs Institute; 2015. 1–24 p. Available from: http://joannabriggs.org/assets/docs/sumari/ReviewersManual_Mixed-Methods-Review-Methods-2014-ch1.pdf
Abidia RF. The expanded role of the dental hygienist: implications for developing countries. J Pak Dent Assoc 2004;13 (3): 99-103.
Hua F, Xie H, Worthington HV, Furness S, Zhang Q, Li C. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev. 2016 Oct 25;10(10):CD008367. doi: 10.1002/14651858.CD008367.pub3.
Zhang TT, Tang SS, Fu LJ. The effectiveness of different concentrations of chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. J Clin Nurs. 2014 Jun;23(11-12):1461-75. doi: 10.1111/jocn.12312.
Takenaka S, Ohsumi T, Noiri Y. Evidence-based strategy for dental biofilms: Current evidence of mouthwashes on dental biofilm and gingivitis. Jpn Dent Sci Rev. 2019 Nov;55(1):33-40. doi: 10.1016/j.jdsr.2018.07.001.
Klompas M, Li L, Kleinman K, Szumita PM, Massaro AF. Associations Between Ventilator Bundle Components and Outcomes. JAMA Intern Med. 2016 Sep 1;176(9):1277-83. doi: 10.1001/jamainternmed.2016.2427.
Klompas M. What is new in the prevention of nosocomial pneumonia in the ICU? CurrOpin Crit Care. 2017 Oct;23(5):378-384. doi: 10.1097/MCC.0000000000000443.
Cristofano A, Peuchot V, Canepari A, Franco V, Perez A, Eulmesekian P. Implementation of a Ventilator-Associated Pneumonia Prevention Bundle in a Single PICU. Pediatr Crit Care Med. 2016 May;17(5):451-6. doi: 10.1097/PCC.0000000000000714.
Blum DFC, Silva JAS, Baeder FM, Bona ÁD. The practice of dentistry in intensive care units in Brazil. RevBras Ter Intensiva. 2018;30(3):327-332. doi: 10.5935/0103-507X.20180044
Souza IS, Santaella NG, Santos PSS. The practice of hospital dentistry in Brazil: an integrative literature review. Rev Bras Odontol. 2017;74(3):232-9. doi: 10.18363/rbo.v74n3.p.232
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2024 Rev Enferm UFPI
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Autores mantém os direitos autorais e concedem à REUFPI o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attibution BY 4.0 que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
