Effect of Oral Health-Based Care Program on Ventilator-Associated Pneumonia in Intensive Care Units: Systematic Review and Meta-Analysis in Iran
Abstract
Background: Ventilator-associated pneumonia (VAP) is a highly prevalent complication of ICU admission. the aim study This systematic review and meta-analysis aimed to determine the effect of an oral care program on oral health (OH) status and prevention of VAP in ICUs in Iran.
Methods: This systematic review and meta-analysis were conducted on the group of articles published on patients hospitalized in ICUs in Iran in 2024. This review included published articles that aimed to assess the effectiveness of care programs or educational interventions in preventing VAP in patients hospitalized in ICUs in Iran. Data search and extraction were performed by two independent researchers in Persian and English between 2004 and 2024. The extracted articles were entered into EndNote software and analyzed using CMA software.
Results: The results showed that, at the beginning of the search, 92 articles were found, and after the final conclusion, five articles entered the meta-analysis stage. Also, VAP prevalence in intervention group was 15% (CI: 6.2-31.9%), and VAP prevalence in control group was 39.5% (CI: 21.1-61.4%).
Conclusion: It is recommended for preventing VAP that OH programs and interventions be carried out in an ICU.
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[16] Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61-e111.
[17] Karimi S, Kolyaei E, Karimi P, Rahmani K. Effectiveness of supervised implementation of an oral health care protocol on ventilator-associated pneumonia patients in intensive care units: a double-blind multicenter randomized controlled trial. Infect Prev Pract. 2023;5(3):100295.
[18] Darbanian N, Nobahar M, Ghorbani R. Effect of propolis mouthwash on the incidence of ventilator-associated pneumonia in intensive care unit patients: a comparative randomized triple-blind clinical trial. BMC Oral Health. 2024;24(1):636.
[19] Guillamet CV, Kollef MH. Ventilator associated pneumonia in the ICU: where has it gone? Curr Opin Pulm Med. 2015;21(3):226-31.
[20] Sands KM, Twigg JA, Wise MP. Oral hygiene with chlorhexidine in critically ill patients. JAMA Intern Med. 2015;175(2):316.
[21] Johnstone L, Spence D, Koziol-McClain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. Pediatr Nurs. 2010;36(2):85-96.
[22] Halili A, Ghafari S, Saghaei M, Atashi V. 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. Med Clin Pract. 2024;7(1):100401.
[23] Haghighi A, Shafipour V, Bagheri-Nesami M, Gholipour Baradari A, Yazdani Charati J. The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients. Aust Crit Care. 2017;30(2):69-73.
[24] Atashi V, Yousefi H, Mahjobipoor H, Bekhradi R, Yazdannik A. Effect of oral care program on prevention of ventilator-associated pneumonia in intensive care unit patients: a randomized controlled trial. Iran J Nurs Midwifery Res. 2018;23(6):486-90.
[25] Khalifehzadeh A, Parizade A, Hosseini A, Yousefi H. The effects of an oral care practice on incidence of pneumonia among ventilator patients in ICUs of selected hospitals in Isfahan, 2010. Iran J Nurs Midwifery Res. 2012;17(3):216-9.
[26] Jun M-K, Ku J-K, Kim I-h, Park S-Y, Hong J, Kim J-Y, et al. Hospital dentistry for intensive care unit patients: a comprehensive review. J Clin Med. 2021;10(16):3681.
[27] Soltani R, Sharifirad G, Mahaki B, Eslami AA. The effect of oral health educational intervention program among mothers of children aged 1-6, based on the theory of planned behavior. J Dent. 2020;21(4):292-9.
[28] Bashirian S, Khoshravesh S, Ayubi E, Karimi-Shahanjarini A, Shirahmadi S, Solaymani PF. The impact of health education interventions on oral health promotion among older people: a systematic review. BMC Geriatr. 2023;23(1):548.
[29] Terezakis E, Needleman I, Kumar N, Moles D, Agudo E. The impact of hospitalization on oral health: a systematic review. J Clin Periodontol. 2011;38(7):628-36.
[30] Dos Santos AA, Silva LDdA, Santos CCdO, Fonseca-Silva T. Oral care practices for patients in intensive care unit: a systematic review. Int J Dent Hyg. 2024;22(1):1-15.
[2] Karami K, Shakerinejad G, Kabiry B. Effect of education based on health belief model on students' oral health behavior change. J Ilam Univ Med Sci. 2014;21(7):134-41.
[3] Jones J, Roberts E, Cockrell D, Higgins D, Sharma D, editors. Barriers to oral health care for autistic individuals—a scoping review. Healthcare. 2024;12(1):1-15.
[4] Karimi Shahanjarini A, Makvandi Z, Faradmal J, Bashirian S, Hazavehei SM. Assessing the tooth decay status of 2-5 years children and the role of their mothers' caring behaviors. Avicenna J Nurs Midwifery Care. 2013;21(4):41-50.
[5] Ebrahimipour H, Mohamadzadeh M, Niknami S, Ismaili H, Vafaii Najjar A. The effect of educational programs based on the theory of planned behavior to improve the oral health behavior of pregnant women attending urban health facilities Ashkhaneh city in 2014. J North Khorasan Univ Med Sci. 2015;7(1):7-18.
[6] Allen F, Tsakos G. Challenges in oral health research for older adults. Gerodontology. 2024;41(1):2-8.
[7] Chanthavisouk P, Ingleshwar A, Theis-Mahon N, Paulson DR. The oral health impact of dental hygiene and dental therapy populations: a systematic review. J Evid Based Dent Pract. 2024;24(1):101949.
[8] Henni SH, Skudutyte-Rysstad R, Ansteinsson V, Hellesø R, Hovden EAS. Oral health and oral health-related quality of life among older adults receiving home health care services: a scoping review. Gerodontology. 2023;40(2):161-71.
[9] Cheon H-W, Yu M-S, Choi M-H. The association of oral diseases and chronic diseases in Korean adult population. J Korean Soc Dent Hyg. 2012;12(2):235-49.
[10] Lee HJ, Huh Y, Sunwoo S. Association between the number of chronic diseases and oral health problems in Korean adults. Oral Health Prev Dent. 2024;22(1):1-10.
[11] Karimian M, Khalighi E, Salimi E, Borji M, Tarjoman A, Mahmoudi Y. The effect of educational intervention on the knowledge and attitude of intensive care nurses in the prevention of pressure ulcers. Int J Risk Saf Med. 2020;31(2):89-95.
[12] Khalighi E, Tarjoman A, Abdi A, Borji M. The prevalence of delirium in patients in Iran: a systematic review and meta-analysis. Future Neurol. 2019;14(4):FNL34.
[13] Mohammadi HR, Erfani A, Sadeghi S, Komlakh K, Otaghi M, Vasig A. Investigating factors affecting mortality due to spinal cord trauma in patients admitted to the intensive care unit. Bull Emerg Trauma. 2024;12(3):136-41.
[14] Mohammadi HR, Asadoola Y, Erfani A, Ghoreishi Amin N, Karimiyarandi H, Sadeghi S, et al. Effectiveness of pulse intravenous infusion of methylprednisolone on pain in patients with lumbar disc herniation: a randomized controlled trial. Anesth Pain Med. 2024;14(4):e149442.
[15] Young PJ, Delaney A, Hills T. Ventilator-associated pneumonia: a problematic outcome for clinical trials. Crit Care Resusc. 2023;25(4):159-60.
[16] Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61-e111.
[17] Karimi S, Kolyaei E, Karimi P, Rahmani K. Effectiveness of supervised implementation of an oral health care protocol on ventilator-associated pneumonia patients in intensive care units: a double-blind multicenter randomized controlled trial. Infect Prev Pract. 2023;5(3):100295.
[18] Darbanian N, Nobahar M, Ghorbani R. Effect of propolis mouthwash on the incidence of ventilator-associated pneumonia in intensive care unit patients: a comparative randomized triple-blind clinical trial. BMC Oral Health. 2024;24(1):636.
[19] Guillamet CV, Kollef MH. Ventilator associated pneumonia in the ICU: where has it gone? Curr Opin Pulm Med. 2015;21(3):226-31.
[20] Sands KM, Twigg JA, Wise MP. Oral hygiene with chlorhexidine in critically ill patients. JAMA Intern Med. 2015;175(2):316.
[21] Johnstone L, Spence D, Koziol-McClain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. Pediatr Nurs. 2010;36(2):85-96.
[22] Halili A, Ghafari S, Saghaei M, Atashi V. 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. Med Clin Pract. 2024;7(1):100401.
[23] Haghighi A, Shafipour V, Bagheri-Nesami M, Gholipour Baradari A, Yazdani Charati J. The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients. Aust Crit Care. 2017;30(2):69-73.
[24] Atashi V, Yousefi H, Mahjobipoor H, Bekhradi R, Yazdannik A. Effect of oral care program on prevention of ventilator-associated pneumonia in intensive care unit patients: a randomized controlled trial. Iran J Nurs Midwifery Res. 2018;23(6):486-90.
[25] Khalifehzadeh A, Parizade A, Hosseini A, Yousefi H. The effects of an oral care practice on incidence of pneumonia among ventilator patients in ICUs of selected hospitals in Isfahan, 2010. Iran J Nurs Midwifery Res. 2012;17(3):216-9.
[26] Jun M-K, Ku J-K, Kim I-h, Park S-Y, Hong J, Kim J-Y, et al. Hospital dentistry for intensive care unit patients: a comprehensive review. J Clin Med. 2021;10(16):3681.
[27] Soltani R, Sharifirad G, Mahaki B, Eslami AA. The effect of oral health educational intervention program among mothers of children aged 1-6, based on the theory of planned behavior. J Dent. 2020;21(4):292-9.
[28] Bashirian S, Khoshravesh S, Ayubi E, Karimi-Shahanjarini A, Shirahmadi S, Solaymani PF. The impact of health education interventions on oral health promotion among older people: a systematic review. BMC Geriatr. 2023;23(1):548.
[29] Terezakis E, Needleman I, Kumar N, Moles D, Agudo E. The impact of hospitalization on oral health: a systematic review. J Clin Periodontol. 2011;38(7):628-36.
[30] Dos Santos AA, Silva LDdA, Santos CCdO, Fonseca-Silva T. Oral care practices for patients in intensive care unit: a systematic review. Int J Dent Hyg. 2024;22(1):1-15.
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How to Cite
1.
Roozegar MA, Vasigh A. Effect of Oral Health-Based Care Program on Ventilator-Associated Pneumonia in Intensive Care Units: Systematic Review and Meta-Analysis in Iran. Arch Anesth & Crit Care. 2025;.
