TAILIEUCHUNG - Báo cáo y học: "Efficacy of oral chlorhexidine in critical care"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Efficacy of oral chlorhexidine in critical care. | Available online http content 12 3 419 Letter Efficacy of oral chlorhexidine in critical care Matt P Wise1 Jade M Cole1 David W Williams2 Mike A Lewis2 and Paul J Frost1 1Adult Critical Care University Hospital of Wales Heath Park Cardiff CF14 4XW UK 2Department of Oral Surgery Medicine Pathology Cardiff University Dental School Heath Park Cardiff CF14 4XY UK Corresponding author Matt P Wise mattwise@ Published 14 May 2008 This article is online at http content 12 3 419 2008 BioMed Central Ltd See related review by Jelic et al. http content 12 2 209 In their review of airway hygiene Jelic and colleagues highlighted that colonization or infection of the upper airway precedes the development of ventilator-associated pneumonia 1 . Although the effects of chlorhexidine on reducing pneumonia were discussed there was no mention of the possible contribution of physical plaque removal in particular tooth brushing which is often performed either infrequently or inadequately in mechanically ventilated patients 1 . Such removal is important because in critically ill patients the normal microflora of dental plaque becomes rapidly colonized by potential pathogens and this biofilm serves as a reservoir for the subsequent development of ventilator-associated pneumonia 2 3 . Physical removal of dental plaque is essential for the optimal benefit of chlorhexidine since its primary action is inhibition of plaque formation. Whilst chlorhexidine kills both Gramnegative bacteria and Gram-positive bacteria by damaging Critical Care 2008 12 419 doi ee6886 their cell wall its antiplaque activity is superior to other antiseptics with greater antibacterial activity. This superior activity occurs because chlorhexidine is absorbed onto oral surfaces and is released over a long period of time. This property known as substantivity explains why chlorhexidine is excellent at inhibiting plaque formation in a clean mouth but is otherwise of .

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