Feng 2012.
| Methods | Study design: A single‐centre RCT with 3 parallel groups (2 groups included in this review) Location: China Number of centres: 1 ICU in a city hospital Study period: February 2009 to January 2011 Funding source: Not stated |
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| Participants | Inclusion criteria: Entry ICU, with orotracheal intubation and ventilation Exclusion criteria: Pulmonary infection, stomatitis or oral tumours before intubation, accompanied by ulcer of the digestive tract, malignant tumours of the body, taking steroids ＞ 3 days, diabetes Number randomised: 204 Number evaluated: 204 Intervention group: 0.05% povidone iodine: n = 71; mean age: 43.7 ± 8.1 years Intervention group: 1/5000 furacilin: n = 65; mean age: 38.5 ± 11.6 years Control group: Saline n = 68; mean age: 40.3 ± 8.5 years Baseline characteristics: Not specified |
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| Interventions |
Comparison: Povidone iodine + toothbrushing versus saline + toothbrushing Group A (n = 71): Toothbrushing along the slits between the teeth with 0.05% povidone iodine by nurses, then the oropharyngeal cavity was rinsed with 50 ml of the solution and it was suctioned out completely. This procedure was repeated 4 times a day Group B: Toothbrushing along the slits between the teeth with 1/5000 furacilin (antibiotic) by nurses. Excluded from this review Control group (n = 68): Toothbrushing along the slits between the teeth with 0.9% saline by nurses, then the oropharyngeal cavity was rinsed with 50 ml of the saline and it was suctioned out completely. This procedure was repeated 4 times a day |
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| Outcomes | 4 outcome variables were reported: 1. Incidence of VAP 2. Rates of oral ulcer or herpes, or both 3. Oral cleanliness ‐ no odour, no foreign bodies and visually clean surfaces of tube and equipment 4. Throat swab culture |
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| Notes | Diagnosis of VAP was according to Chinese Society of Respiratory Diseases criteria | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | "Patients were divided into three groups according to randomisation principle" |
| Allocation concealment (selection bias) | Unclear risk | Not specified |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding not described and not possible for the caregivers who would be aware of who was in each group |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not specified |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | All randomised participants included in the outcome evaluation |
| Selective reporting (reporting bias) | Low risk | The results were fully reported |
| Other bias | Low risk | No other sources of bias identified |