Role of Oral Care in Prevention of Nosocomial Pneumonia Among COPD Patients

NCT ID: NCT06691399

Last Updated: 2024-11-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-01

Study Completion Date

2025-06-01

Brief Summary

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Poor dental hygiene has been linked to respiratory pathogen colonization in ICU patients. Therefore, respiratory pathogens tend to colonize dental plaque and oral mucosa in these populations. Therefore, strategies to eliminate respiratory pathogens from the oral cavity may improve oral hygiene and decrease the development of nosocomial pneumonia.

Detailed Description

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Infection is a common problem and a major cause of morbidity and mortality for patients in intensive care units (ICUs). Pneumonia is the most common site of infection according to an international study of the prevalence and outcomes of infection in ICUs, which included 13,796 patients. Nosocomial pneumonia (NP) is among the leading causes of mortality in patients in the ICU. Notably, the incidence of nosocomial pneumonia is increasing, and the number of infection-related deaths that follow is also increasing. Thus, preventing nosocomial pneumonia is a cost reducing and life-saving health care practice, especial in ICUs.

Nosocomial pneumonia (NP) was defined as an infection of the lower respiratory tract that does not exist at the time of admission and does not have an incubation period of infection but occurs 48 hours after admission. The most important cause for the development of nosocomial pneumonia is the oral environment. The oral cavity of ICU patients is an important reservoir for bacteria and provides a habitat for microorganisms that can lead to nosocomial pneumonia. Patients in ICUs acquire pneumonia by aspirating oral bacteria that have been colonized in the oral cavity into the lower respiratory tract. Due to advanced age, limited mobility, illness, and cognitive dysfunction, patients in ICUs often have difficulty maintaining oral hygiene by themselves.

Poor dental hygiene has been linked to respiratory pathogen colonization in ICU patients. Therefore, respiratory pathogens tend to colonize dental plaque and oral mucosa in these populations. Therefore, strategies to eliminate respiratory pathogens from the oral cavity may improve oral hygiene and decrease the development of nosocomial pneumonia. The aim of the present study is to assess value of preventive strategy using chlorhexidine for oral care among non-intubated COPD patients admitted to ICU upon incidence of nosocomial pneumonia.

Conditions

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Nosocomial Pneumonia COPD Exacerbation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Routine oral care (Group 1)

Group (1) will receive routine oral care twice daily with gauze for cleansing and tooth brushing

Group Type PLACEBO_COMPARATOR

Oral care

Intervention Type OTHER

Oral care done twice daily with chlorhexidine oral care solution (concentration 1.2%)

Chlorhexidine oral care

Group (1) will receive routine oral care twice daily with gauze for cleansing and tooth brushing plus oral care with chlorohexidine solution (concentration 1.2%)

Group Type ACTIVE_COMPARATOR

Oral care

Intervention Type OTHER

Oral care done twice daily with chlorhexidine oral care solution (concentration 1.2%)

Interventions

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Oral care

Oral care done twice daily with chlorhexidine oral care solution (concentration 1.2%)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients diagnosed as COPD
* admitted to ICU with acute exacerbation
* need for noninvasive ventilatory support including noninvasive ventilation anf high flow nasal cannula

Exclusion Criteria

* patients refusing to participate
* End stage organ failure (Heart Failure, Liver cell failure and/or Renal failure
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Waleed Gamal Elddin Khaleel

Assistant Professor of Chest Diseases

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Waleed MD Gamal Elddin Khaleel, Ass. Prof.

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Locations

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Faculty of Medicine, Assiut University

Asyut, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Waleed MD Gamal Elddin Khaleel, Ass. Prof.

Role: CONTACT

+201006519722

Maiada MD Kamaleldin Hashem, Ass. Prof.

Role: CONTACT

+201006559662

Facility Contacts

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waleed MD Gamal Elddin Khaleel, Ass. Prof.

Role: primary

+201006519722

Maiada MD Kamaleldin Hashem, Ass. Prof.

Role: backup

+201006559662

References

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Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K; EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009 Dec 2;302(21):2323-9. doi: 10.1001/jama.2009.1754.

Reference Type BACKGROUND
PMID: 19952319 (View on PubMed)

Vilela MC, Ferreira GZ, Santos PS, Rezende NP. Oral care and nosocomial pneumonia: a systematic review. Einstein (Sao Paulo). 2015 Apr-Jun;13(2):290-6. doi: 10.1590/S1679-45082015RW2980. Epub 2015 May 1.

Reference Type BACKGROUND
PMID: 25946053 (View on PubMed)

Other Identifiers

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SOD2024

Identifier Type: -

Identifier Source: org_study_id

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