Comparison of Blue®m and chlorhexidine mouthwash on oral health of intubated patients in intensive care unit

This research aims to evaluate whether blue®m mouthwash can be used as a suitable alternative to chlorhexidine mouthwash for improving the oral health of intubated patients in ICUs. This is a randomized clinical study. The sample comprised 50 mechanically ventilated adults randomly allocated in a block of 10 to the 0.12% chlorhexidine digluconate (CHX) and the blue®m group. The patients' oral and tracheal secretions were collected in four different periods: T1 - 24h after intubation (without sanitation); T2 - 24h after intubation (with sanitation); T3 - 48h after intubation (without sanitation); T4 - 48h after intubation (with sanitation). Bacterial and fungal identification was performed. The presence of bacteria was graded as abundant, moderate, and scarce. Descriptive and inferential statistics were performed. Fifty patients with a mean age of 62.7 ± 13.3 years (20 to 86 years) were treated, 24 in the CHX group and 26 in the blue®m group. The most frequent pathogens in the patient's oral environment were Acinetobacter baumanii, Pseudomonas aeruginosa, and Klebsiella pneumonia. Analysis of the effectiveness of both antiseptics indicated statistically significant differences in the median values of the microbial population between collection periods in the CHX (χ2=13.2, p=0.004) and blue®m (χ2=9.49, p=0.023) group. No significant statistical difference in microbial population was found between the groups (T1- p=0.375; T2 - p=0.955; T3 - p=0.765; T4 - p=0.898). Blue®m mouthwash effectively reduces the oral microbial population and does not differ from chlorhexidine in terms of reduction. Blue®m mouthwash can be used as an alternative to chlorhexidine for mechanical ventilator patients in the ICU.