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De-adoption of oral chlorhexidine for mechanically ventilated patients: get thee to a conclusion.
Acute Crit Care
August 2022
Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Qatar.
De-adoption of chlorhexidine oral care and ICU mortality. Authors' reply.
Intensive Care Med
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Sunnybrook Research Institute, Toronto, Canada.
De-adoption of chlorhexidine oral care and ICU mortality.
Intensive Care Med
May 2022
School of Healthcare, Nurse Education Programme, HOGENT University of Applied Sciences and Arts, Ghent, Belgium.
Effect of oral chlorhexidine de-adoption and implementation of an oral care bundle on mortality for mechanically ventilated patients in the intensive care unit (CHORAL): a multi-center stepped wedge cluster-randomized controlled trial.
Intensive Care Med
November 2021
Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Purpose: Oral chlorhexidine is used widely for mechanically ventilated patients to prevent pneumonia, but recent studies show an association with excess mortality. We examined whether de-adoption of chlorhexidine and parallel implementation of a standardized oral care bundle reduces intensive care unit (ICU) mortality in mechanically ventilated patients.
Methods: A stepped wedge cluster-randomized controlled trial with concurrent process evaluation in 6 ICUs in Toronto, Canada.
Protocol for a multi-centered, stepped wedge, cluster randomized controlled trial of the de-adoption of oral chlorhexidine prophylaxis and implementation of an oral care bundle for mechanically ventilated critically ill patients: the CHORAL study.
Trials
October 2019
Sunnybrook Research Institute, Toronto, Canada.
Background: Routine application of chlorhexidine oral rinse is recommended to reduce risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. Recent reappraisal of the evidence from two meta-analyses suggests chlorhexidine may cause excess mortality in non-cardiac surgery patients and does not reduce VAP. Mechanisms for possible excess mortality are unclear.
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