The effect of chlorhexidine gluconate, sodium bicarbonate, ozonated water and hypochlorous acid solutions used in oral care on preventing ventilator-associated pneumonia

Objective: The objective of this study was to compare the effects of 0.12% chlorhexidine gluconate, 1% chlorhexidine gluconate, sodium bicarbonate, ozonated water, and hypochlorous acid solutions used in oral care for patients on mechanical ventilation support in preventing ventilator-associated pneumonia. Material and Methods: The study was a randomised controlled trial conducted between June 2023 and June 2025 at the Anesthesia and Reanimation Intensive Care Unit of Nazilli State Hospital, Ministry of Health, Türkiye, involving 105 patients. The data were collected using a questionnaire prepared by the researchers. The analysis of the data was conducted using a range of statistical tests, including descriptive statistics, chi-square, likelihood ratio, Friedman, and Mann-Whitney U tests. Results: The mean age of the patients participating in the study was 69.62 years (±13.29), and 65.7% of them were male. During the initial three days of treatment, mild dysfunction of the oral mucosa was observed in all patients. The mean scores obtained from the oral assessment scale on all days were found to be low in patients who underwent oral care with ozonated water, hypochlorous acid, and 1% chlorhexidine gluconate, while the mean scores obtained from the oral assessment scale on all days were high in patients who underwent oral care with 0.12% sodium bicarbonate. No significant difference was identified between the groups with regard to the occurrence of ventilator-associated pneumonia (χ² = 6.182, p = 0.186). Conclusion: The study concluded that ozonated water and hypochlorous acid were the most effective oral care solutions for maintaining oral mucosal membrane integrity and preventing VAP in patients on mechanical ventilation. It is recommended that ozonated water and hypochlorous acid solutions be used in oral care protocols within intensive care units. Keywords: Chlorhexidine Gluconate, Nursing Care, Oral Mucosa, Sodium Bicarbonate, Ventilator-Associated Pneumonia.