Effectiveness of Chinese herbal medicine mouthwash in preventing ventilator-associated pneumonia in patients with endotracheal intubation: A systematic review and meta-analysis
Abstract
Background: To systematically evaluate the effectiveness and safety of Chinese herbal medicine mouthwash (CHMM) in preventing ventilator-associated pneumonia (VAP) in patients with endotracheal intubation (ETT). Methods: Computer searches were conducted for relevant randomized controlled trials (RCTs) in the China National Knowledge Infrastructure (CNKI), WANFANG DATA, Chinese Scientific and Technical Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), PubMed, Embase, Cochrane Library, and CINAHL Database from the establishment to April 5, 2023. The data were analyzed by RevMan 5.3 software. The methodological quality of papers was evaluated by the Cochrane version 5.1.0 and the certainty of evidence was evaluated by the GRADE system. Results: We included 27 RCTs with 2426 patients. Most of the included studies were of poor methodological quality. Meta-analysis showed that CHMM (RR = 0.41, 95% CI: 0.34–0.50, P < .00001, low-certainty evidence) or CHMM + routine oral care (RR = 0.31, 95% CI: 0.18–0.56, P < .0001) could reduce the incidence of VAP compared to non-CHMM. CHMM may be superior to saline (low-certainty evidence) and chlorhexidine (moderate-certainty evidence) in preventing VAP (P < .05). Conclusion: Low-certainty evidence shows that CHMM may be more advantageous in reducing the incidence of VAP compared to non-CHMM. However, due to some limitations and the low certainty of evidence, we cannot recommend CHMM for routine clinical use at this…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,426 participants or records.
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