The importance of oral care in the prevention of ventilatory pneumonia (VAP) in pediatric intensive care units

The aim of this study is to evaluate the importance of comprehensive oral care / hygiene in the prevention of ventilator-associated pneumonia in pediatric intensive care units. The sample of the study consisted of 112 children between the age of 0-18, without a history of pneumonia, who were at least 48 hours connected to the mechanical ventilator of İstanbul Medeniyet University Göztepe Training and Research Hospital Pediatric Intensive Care Unit between July 2018 and March 2019. VAP developed in 33 children in the study. SPSS v21 (SPSS Inc., Chicago, IL, USA) software was used in the evaluation of the findings. The suitability of the variables to normal distribution was evaluated by Shapiro Wilk test. The analysis of the variables that did not provide a normal distribution assumption was performed by Mann Whitney U test. p <0.05 was considered statistically significant. According to the results, the incidence of VAP was found to be higher in pediatric patients. The development of VAP was mostly seen in patients presenting with lung disease (32.9%). PRISM score, time to start enteral feeding, mortality, presence of infection at presentation were similar in patients with and without VAP. Antibiotic use was similar in patients with and without VAP. Ceftriaxone was the most commonly used antibiotic. It was found that the duration of hospitalization, length of hospital stay and duration of ventilator stay were higher in patients with VAP than in the group without VAP. Oral mucosal evaluation score was found to be high in patients with VAP glowing. Klebsiella pneumoniae is the most common microorganism in patients with VAP. The incidence of VAP decreased from 6.3 / 1000 ventilator days in januaryfebruary-march 2018 to 0/1000 ventilator days in January-February-March 2019. Giving training to nurses about oral care practices and establishing the oral care protocol increased the quality of care given to the patient. Providing effective and comprehensive oral care prevents the risk of developing VAP at a high rate. Keywords: mechanical ventilator, ventilator-associated pneumonia, oral care, VIP incidence.