Table 2 Summary of systemic reviews findings on the effect of chlorhexidine used in ICUs
From: Oral health care for the critically ill: a narrative review
Study | Intervention/comparisons | Outcomes | Relative effect | Number of participants | Grade |
|---|---|---|---|---|---|
Zhao et al. [46] China | CHX (mouth rinse or gel) versus placebo/usual care | VAP | CHX reduced VAP: RR 0.67 (95% CI 0.47–0.97) | 1206 (13 studies) | ⨁⨁⨁◯ Moderate |
Mortality | No difference RR 1.03 (95% CI 0.80 to1.33) | 944 (9 studies) | ⨁⨁⨁◯ Moderate | ||
ICU stay | No difference 0.89 (95%CI-3.59–1.82) | 627 (5 studies) | ⨁⨁◯◯ Low | ||
Silvestri et al. [69] Italy | CHX (0.12–0.2% solution or gel) versus placebo, usual care | Mortality | No difference OR: 0.69 (95% CI 0.31–1.53)a | 1655 (5 studies) | Not reported |
Bloodstream infection | No difference OR: 0.74; 95% CI 0.37–1.50 | ||||
Hua et al. [63] China | CHX (mouth rinse or gel) versus placebo/usual care | VAP | CHX reduced VAP RR 0.75 (95% CI 0.62–0.91) | 2451(18 studies) | ⨁⨁⨁⨁ High |
Mortality | No difference RR 1.09 (95% CI 0.96–1.23) | 2014(14 studies) | ⨁⨁⨁◯ Moderate | ||
ICU stay | No difference 0.21 (95%CI -1.48 -1.89) | 833 (6 studies) | ⨁⨁⨁◯ Moderate | ||
Villar et al. [70] Brazil | CHX (0.12–2% solution, gel or foam) versus placebo or usual care | VAP | No difference with 0.1 and 0.2% 2% CHX reduced VAP RR:0.53 (95% CI 0.31–0.91) | 1640 (13 studies) | Not reported |
Klompas et al. [47] USA | Interventions: CHX (0.12–2% solution, or gel) versus placebo/usualcare | VAP | CHX reduced VAP RR, 0.56 (95% CI, 0.41–0.77) in CS No significant difference for NCS RR, 0.88 (95% CI, 0.66–1.16) | 1868 (3 studies) | Not reported |
Mortality | No difference: CS RR, 0.88 (95% CI, 0.25–2.14) NCS RR, 1.13, 95% CI, 0.99–1.29 | 1762 (13 studies) | Not reported | ||
Price et al. [48] UK | SDD, SOD and topical oropharyngeal CHX versus usual care | Mortality | SDD reduced mortality OR 0.73 (95%CI 0.64–0.84) | 7839 (15 studies) | Not reported |
SOD reduce mortality OR 0.85 (95%CI 0.74–0.97) | 4276 (4 studies) | Not reported | |||
CHX increased mortality OR 1.25 9% CI 1.05–1.50 | 2618 (11 studies) | Not reported |