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Reduce VAP with Oral Care
Ventilator Associated Pneumonia (VAP) causes prolonged intubation and a prolonged stay in intensive care units (ICU) with the associated costs. It is also a serious cause of mortality in compromised patients.
A combination of oral care treatments (brushing and suctioning) as part of a proper oral care protocol means care providers can ef ciently prevent build up of oropharyngeal bacterial bio lm. This in turn leads to a reduction of VAP and aspiration pneumonias and greatly reduces associated treatment costs.1.2.3.
VAP Fact 1: VAP occurs in 9–25% of all patients in ICU
VAP Fact 2: Each case of VAP costs the hospital $30,000–$40,000 VAP Fact 3: VAP mortality rate is approximately 10–40%
Four stages of plaque build up
Dental plaque is a bio lm made up of bacteria and their excretions, sitting mainly at the gum line and between teeth.
Bio lm
Fresh bio lm will develop after each intervention and will cover
the complete tooth surface in only two hours. The bio lm protects pathogenic bacteria such as MRSA and Klebsiella, which are common problems in many intensive care units. Bio lm must be broken up prior to the application of antibacterial agents.
Aspiration
From the oropharynx saliva, mucous and bio lm build-up move to the ET tube cuff and may be aspirated into the lungs, as the cuff seal will never be 100%. When aspirated into the lungs, these bacteria may cause VAP and require treatment with antibiotics.
Stage 1 Attachment
Tooth surface
Stage 3 Secondary
Extracellular Fluid slime layer channels
Bio lm sits mainly at the gum line and between the teeth
Protocols and Assessment Guides
As patients have quite different oropharyngeal conditions, which may change quickly during their hospital stay, the status of the oropharynx needs to be assessed as a daily routine. We have created an assessment guide which can be downloaded to help start the process.
Supporting videos
Learn more about Oral care
www.intersurgical.co.uk/info/oralcare
References
1. R. Garcia, L. Jendresky, L. Colbert, A. Bailey, M. Zaman et M. Majumder, Reducing Ventilator-Associated Pneumonia Through Advanced Oral-Dental Care: A 48-Month Study, AJCC, July 2009. 2. J. Rello, D. Ollendorf, G. Oster, M. Vera-Llonch, L. Bellm, R. Redman, M. Kollef: Epidemiology and outcomes of ventilator-associated-pneumonia in a large US database, Chest, December 2002.
3. L. Frampton: Preventig HCAI on the intensive care unit, The Clinal Services Journal, March 2014.
For correct set-up and connection of the Intersurgical Oral Care products, please view the appropriate video.
Stage 2
Initial
colonization colonization
Stage 4 Mature bio lm
Bacterial micro- colonies
Trachea
ET Tube Cuff
AIR/Sputum/ Bacteria
www.intersurgical.co.uk/products/critical-care/oral-care#videos
Contact us 0118 9656 300 • info@intersurgical.co.uk • www.intersurgical.co.uk
Oral Care
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