PENGARUH TINDAKAN ORAL HYGIENE MENGGUNAKAN CHLORHEXIDINE 0,20% TERHADAP KEJADIAN VAP (VENTILATOR ASSOCIATED PNEUMONIA) PADA PASIEN DENGAN VENTILATOR MEKANIK DI RUANG OBSERVASI INTENSIF (ROI)

Abstract

Ventilator Associated-Pneumonia (VAP) is described as the most common nosocomial infection in the intensive care units and is often fatal.VAP is defined as pneumonia which occurr more than 48 hours after patients have been intubated and received mechanical ventilation. Oral hygiene with chlorhexidine is one of strategis that is proposed to prevent VAP.

The aim of this study was to analyze the effect of chlorhexidine used in oral hygiene on the incident of VAP at ROI. The population consisted of all patients that have been using mechanical ventilation for more than 48 hours in ROI. Total sample were 10 respondents, received oral hygiene with chlorhexidine routinely twice a day. The independent variable was oral hygiene with chlorhexidine 0,20% and dependent variable was 5 variable of modified CPIS (body temperature, blood leukocytes, tracheal secretions, oxygenation, pulmonary radiography and progressive of pulmonary infiltrate). Data were collected by using observation sheet and analyzed with Wilcoxon Signed Rank Test with level of significance=0.05.

Wilcoxon Signed Rank Test calculation, resulted that oral hygiene with chlorhexidine 0,20% had significant effect in major of variable: CPIS score including body temperature, blood leukocytes, oxygenation, pulmonary radiography and progressive of pulmonary infiltrat (p<0.05). However, tracheal secretions showed unsignificant relation. Although an increased volume and purulence of tracheal secretions are criteria of VAP but only few of ventilated patients with purulent tracheal aspirates caused by certain of bacteria that can be found in microbiological tests. It can caused by others situation such ARDS or COPD.

It can be concluded that oral hygiene using chlorhexidine 0,20% can reduce incident of VAP