Does chlorhexidine reduce the incidence of ventilator-associated pneumonia in ICU patients? A systematic review and meta-analysis
Abstract
OBJECTIVE
This study aimed to investigate chlorhexidine's efficacy in preventing ventilator-associated pneumonia (VAP).
DESIGN
A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
SETTINGS
The data were obtained from Pubmed, Cochrane Library, and EMBASE.
PATIENTS OR PARTICIPANTS
Only mechanically ventilated patients for at least 48h were included.
INTERVENTIONS
Randomized clinical trials applying any dosage form of chlorhexidine were eligible.
MAIN VARIABLES OF INTEREST
The relative risk (RR) of the VAP incidence and all-cause mortality was assessed using the random-effects model. The mean difference in days of mechanical ventilation duration and intensive care unit (ICU) length of stay were also appraised.
RESULTS
Ten studies involving 1233 patients were included in the meta-analysis. The oral application of CHX reduced the incidence of VAP (RR, 0.73 [95% CI, 0.55, 0.97]) and did not show an increase in all-cause mortality (RR, 1.13 [95% CI, 0.96, 1.32]).
CONCLUSIONS
CHX proved effective to prevent VAP. However, a conclusion on mortality rates could not be drawn because the quality of the evidence was very low for this outcome.
How strong is the evidence?
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: 1,233 participants or records.
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