Does oral povidone-iodine therapy for critically ill patients in the intensive care unit provide any benefit in terms of preventing ventilator-associated pneumonia?

Article Type : Correspondence

Authors

1 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran

3 Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran

To the Editor

One of the most prevalent and significant consequences in patients who are mechanically ventilated (MV) is ventilator-associated pneumonia (VAP). VAP is undoubtedly linked to higher rates of mortality, morbidity, and length of stay (LOS) in the intensive care unit (ICU) [1-3]. Also, VAP increases the risk of 30-day mortality by 38% [4]. Therefore, it is essential to implement an appropriate prevention strategy to improve the prognosis and reduce mortality [5, 6]. Although some studies have shown that oral care with povidone-iodine (PI) is effective in the prevention of VAP among critically ill patients [5, 7], regarding how PI affects VAP prevention, there is still no consensus [8, 9].

According to a study conducted in Indonesia, oral care with PI and VAP prevalence among critically ill ICU patients are related [10]. On the other hand, a study in Japan found that topical PI inhibits the growth of bacteria in the oral cavity [2]. Consistent with these findings, another study in France has shown that oropharyngeal decontamination with PI significantly reduces the incidence of VAP in patients with head trauma. They indicated that oropharyngeal decontamination with PI did not affect reducing mortality and LOS in the ICU [5]. Additionally, a study conducted in the Philippines found that using PI as an oral rinse did not significantly lower the prevalence of VAP in ICU patients. They found that oral rinse with PI did not affect reducing mortality, intubation duration, and LOS in the ICU [8]. Another study in India indicated that oral care with PI was more likely to cause VAP in ICU patients than chlorhexidine [7]. In contrast to earlier findings, a French study discovered that oral care with PI increased VAP incidence among ICU patients, however, this increase was not statistically significant. Also, oral care with PI did not affect reducing mortality and LOS in the ICU [9].

In conclusion, it appears that employing oral care with PI is useful in preventing VAP among critically ill ICU patients; however, additional research, including randomized clinical trials, is needed to determine the efficacy of this prevention method.

 

Acknowledgements

Not applicable.

 

Authors’ contributions

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: MJG, MM, AEZ; Drafting the work or revising it critically for important intellectual content: MJG, MM, AEZ; Final approval of the version to be published: MJG, MM, AEZ; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: MJG, MM, AEZ.

 

Funding

Self-funded.

 

Ethics approval and consent to participate

Not applicable.

 

Competing interests

We do not have potential conflicts of interest with respect to the research, authorship, and publication of this article.

 

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (CC BY-NC 4.0).

© 2023 The Author(s).

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Volume 1, Issue 1
April 2023
Pages 55-56
  • Receive Date: 10 February 2023
  • Revise Date: 11 February 2023
  • Accept Date: 11 February 2023
  • First Publish Date: 24 May 2023
  • Publish Date: 24 May 2023