Abstract | OBJECTIVE: DESIGN: Double blind randomized placebo controlled trial. SETTING: Pediatric intensive care unit of a tertiary care hospital in North India. PATIENTS: Eligible participants were patients aged 3 months to 15 yrs who required orotracheal or nasotracheal intubation and mechanical ventilation. Two hundred eighty-three children admitted to the pediatric intensive care unit between November 2007 and April 2009 were screened. Eighty-six patients fulfilled the study requirements. INTERVENTION: Either 1% chlorhexidine or placebo gel was applied on the buccal mucosa at 8-hr intervals for the entire duration of ventilation, subject to a maximum of 21 days. Patients were followed up for the development of ventilator-associated pneumonia, diagnosed using the Centers for Disease Control and Prevention criteria. MAIN OUTCOME MEASURES: RESULTS: Fourty-one children received 1% chlorhexidine, whereas 45 received placebo application. Patients of both groups were comparable with respect to baseline characteristics. Incidence of ventilator-associated pneumonia was 39.6/1,000 ventilator days with 1% chlorhexidine and 38.1/1,000 ventilator days with placebo (relative risk 1.03, confidence interval 0.44-2.42, p = .46). The duration of intensive care unit stay and hospital stay was a mean of 8.4 ± 5.8 vs. 9.6 ± 11.4 days (p = .58) and 16.1 ± 10.2 days vs. 15.1 ± 14.3 days (p = .19) with chlorhexidine and placebo, respectively. The mortality rates were similar in the two groups (p = .81). All but two isolates causing ventilator-associated pneumonia were gram-negative, with Acinetobacter species being the most common (14 of 26). No side effects of the applied gel were seen in either group. CONCLUSION:
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Authors | Meghna Raju Sebastian, Rakesh Lodha, Arti Kapil, Sushil K Kabra |
Journal | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
(Pediatr Crit Care Med)
Vol. 13
Issue 5
Pg. e305-10
(Sep 2012)
ISSN: 1529-7535 [Print] United States |
PMID | 22760426
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Infective Agents, Local
- Chlorhexidine
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Topics |
- Acinetobacter
- Acinetobacter Infections
(complications)
- Administration, Topical
- Adolescent
- Anti-Infective Agents, Local
(administration & dosage, therapeutic use)
- Child
- Child, Preschool
- Chlorhexidine
(administration & dosage, therapeutic use)
- Decontamination
- Double-Blind Method
- Female
- Humans
- Infant
- Intensive Care Units, Pediatric
- Length of Stay
- Male
- Mouth Mucosa
(microbiology)
- Pneumonia, Ventilator-Associated
(microbiology, prevention & control)
- Respiration, Artificial
(adverse effects)
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