Prevention of Pneumonia due to Ventilator in Critical Patients with U Shape Oral Hygiene Model: A Systematic Review

In critical patients, generally, microorganisms originating from nasal cause Ventilator-Associated Pneumonia (VAP). This systematic review was aimed to identify the toothbrush U shape model usage, in potentially decrease the prevalence of ventilator-associated pneumonia among patients in intensive care units. Search strategy identified 15 potentially eligible articles, were 7 RCTs, 4 Meta-analysis, and 4 Observational studies. A total of 15 studies demonstrated the use of toothbrushing and chlorhexidine in mechanically ventilator patients in preventing VAP. Ten studies found positive association between toothbrushing and the use of chlorhexidine in preventing VAP. However, there were 5 studies that did not reveal an additional decrease of VAP incidence either of CHX and only toothbrushing or combination thereof. We cautiously assumed that toothbrushing and chlorhexidine might reduce VAP but the implementation of brushing should be taken into reconsideration in the terms of maintaining it.