Effects of oral care with glutamine in preventing ventilator-associated pneumonia in neurosurgical intensive care unit patients

- Ventilator-associated pneumonia is one of the most frequent nosocomial infections in intensive care unit patients.
- One of the measures to prevent the development of VAP is applying good oral care.
- A range of antiseptic solutions are used for oral care.
- Glutamine was reported to be an essential amino acid in critically ill patients.

PurposeThe study was designed as a randomized, controlled, experimental study aiming to determine the effects of oral care with glutamine in preventing ventilator-associated pneumonia in patients admitted to neurosurgical intensive care unit.MethodsThe universe consisted of patients who are admitted to neurosurgical intensive care unit between January 2014 and August 2015, while the sample consisted of 88 patients who fulfilled the inclusion criteria and were randomly selected. The study group received oral care with 5% glutamine, whereas the control group received oral care with 2% chlorhexidine gluconate solution.Data collecting toolsAll date was acquired using Patient Information Form, Acute Physiological and Chronic Health Evaluation scale (APACHE II), Beck Oral Assessment Scale (BOAS), Mucosal Plaque Score (MPS) and Clinical Pulmonary Infection Score (CPIS). One-way ANOVA test was used for comparing parameters with normal distribution between groups along with descriptive statistical methods. Kruskal-Wallis Test was used for comparing parameters without normal distribution between groups.ResultsIn the control group, mean BOAS score was 9.33 ± 1.8 mean MPS score was 3.68 ± 0.87 and mean CPIS score was 4.07 ± 1.78. In the study group, mean BOAS score was 10.16 ± 2.78, mean MPS score was 3.93 ± 1.04 and mean CPIS score was 3.78 ± 2.25. There was no statistically significant difference in mean scores at 1st day, 3rd day, 5th day and discharge (p > 0.05). However, BOAS, MPS, CPIS and APACHE II scores was significantly lower at discharge than 1st day in both groups.ConclusionThere was no significant difference in using 5% glutamine or 2% chlorhexidine gluconate solution for oral care for the prevention of ventilator-associated pneumonia. Similar studies with bigger sample size and longer term should be conducted for better results.