This study was conducted as randomized controlled, double-blind and experimental to determine the most effective chlorhexidine concentration in reducing the microbial colonization in patients with mechanical ventilator. The sample of the study consists of 116 patients hospitalized in Republic of Turkey Ministry of Health, Provincial Health Directorate Aydin Nazilli State Hospital Anesthesiology and Reanimation Intensive Care Unit between the dates of February-December 2019. Patients were randomly assigned to four groups. The patients in the first group, 2% chlorhexidine gluconate, the ones in the second group 1% chlorhexidine gluconate, the ones in the third group 0.2% chlorhexidine gluconate and the others in the fourth group 0.12% oral chlorhexidine gluconate were administered oral care four times a day aligning with the application protocol. Descriptive Characteristics Form, Patient Follow-up Form, Microbiological Follow-up Form and Oral Assessment Guide were used to obtain data.
The mean age of the patients was 70.00 ± 15.57 and 62.1% of them were male. Mild dysfunction was detected in the oral mucosa of all the patients all days in all of the chlorhexidine gluconate solution used in oral care. The difference in the mean scores obtained from the oral assessment scale among all days was found to be statistically significant among the patients who had oral care with 1% and 2% chlorhexidine gluconate (p <0.001), the difference in the mean scores obtained from the oral assessment scale among all days was not found to be statistically significant among the patients who had oral care with 0.2% and 0.12% chlorhexidine gluconate (p>0.001). In oral care, it was found out that there was a statistically significant difference in the sample of oral mucosa taken from the patients who had oral care with 1% chlorhexidine gluconate solution in terms of microorganisim reproductivity.
According to the findings of the study, it is concluded that 1% concentration of chlorhexidine gluconate solution is the most effective in preventing oral microbial colonization in oral care applied to patients with mechanical ventilation support.
Keywords: Mechanical ventilation, oral care, clorhexidine gluconate, microbial
colonization, intensive care unit