Protocolos de higiene bucal para paciente em unidade de terapia intensiva - uma revisão de literatura

Abstract

Patients in intensive care units (ICU) have oral hygiene inadequate, resulting in the accumulation of dental biofilm and favoring the occurrence of ventilator-associated nosocomial pneumonia (VAP). The present review of literature analyzed the effectiveness of different oral hygiene protocols and different oral antiseptics in patients hospitalized in ICUs. The period of selection of articles was between January and July 2021. Articles relevant to the topic were included, in the languages in Portuguese, English and Spanish. Although there are several ways to control the biofilm, there is still no established protocol for oral hygiene of patients undergoing mechanical ventilation, having identified different methods including the use of products various antiseptics, such as chlorhexidine, at concentrations of 0.12, 0.2 and 2%, associated or not to a mechanical method of removing dental biofilm. In some protocols, it is suggested the use of more than one substance, such as hydrogen peroxide, associated with chloride of cetylpyridinium or chlorhexidine. Among all oral antiseptics, chlorhexidine remains as the product of choice among professionals. The present study concluded that the more comprehensive protocols, involving measures other than mechanical methods (brushing) and pharmacological (mouthwashes) were more efficient in prevention and reduction of VAP. And, that antiseptics are very important for the reduction of the rate of this infection, and, although several substances have been tested, the gluconate of chlorhexidine is the most indicated by the authors.