Ventilator-associated Pneumonia Clinical Trial
Official title:
A Randomized Controlled Clinical Trial of Two Different Oral Care Regimens Combined With Ventilator-Associated Pneumonia (VAP) Bundle Strategy for Reduction of Duration of Mechanical Ventilation in a Neonatal Population
The goal of this pilot study is to test the hypothesis that mechanically ventilated infants receiving Biotene OralBalance® gel for oral care would have a reduced intubation time compared to infants receiving oral care placebo. This study is also performed to test the feasibility as well the safety of Biotene OralBalance® gel.
Prolonged mechanical ventilation is a known risk factor strongly associated with
ventilator-associated pneumonia (VAP). As the fatality rates for VAP are high, prevention of
VAP has focused on the use of "VAP bundles". Oral decontamination, by reducing the microbial
burden within a patient's oral cavity, is an essential part of VAP bundle strategy for
reducing VAP rates in mechanically ventilated adults and older children. However there are no
published studies of oral care products for VAP prevention in mechanically ventilated
neonates. Biotene OralBalance® gel contains antibacterial active ingredients, including
lactoperoxidase, lysozyme and lactoferrin,all enzymes with bacteriostatic or bactericidal
activity on selective oral microflora. We hypothesize that by directly reducing the oral
microbial burden, we indirectly reduce the number of VAP. This will be reflected in the
reduced time on mechanical ventilation in the group of infants receiving Biotene OralBalance®
gel.
This is a prospective, randomized, unmasked, controlled trial with 40 mechanically ventilated
infants recruited from level IV nursery at Forsyth Medical Center, Winston-Salem, NC. The
participants will be randomized to two equal groups, stratified by gestational age
categories: <28 weeks, and >=28 weeks as well as multiple births. Twenty infants will receive
Biotene OralBalance® gel (Intervention Group) and 20 infants will receive swabs with sterile
water (Control Group) for timed oral care. Both study groups will receive the NICU standard
ventilator-associated pneumonia (VAP) bundle, a combination of strategies aimed to reduce the
rate of VAP.
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