Zhao 2012.
| Methods | Study design: A single‐centre RCT with 2 parallel groups Location: China Number of centres: 1 surgical ICU in city hospital Study period: May 2010 to April 2011 Funding source: Not stated |
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| Participants | Inclusion criteria: Admission into the ICU, orally intubated, receiving mechanical ventilation Exclusion criteria: Not specified Number randomised: 324 (162 per group) Number evaluated: 324 Age group: Mean 66.25 ± 15.28 Baseline characteristics were comparable |
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| Interventions |
Comparison: Yikou (triclosan) rinse versus saline Experimental group: Oral cavity swab with 15 ml of Yikou gargle (triclosan is main ingredient), 4 times a day Control group: Oral cavity swab with normal saline, 4 times a day Secretions were aspirated using suction once daily and sent to lab for culture |
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| Outcomes | 3 outcome variables were available: 1. Incidence of VAP in < 4 days of ventilation and within 4 ‐ 10 days of ventilation 2. Mechanical ventilation days 3. ICU stay days 4. Culture of the samples taking from oropharyngeal cavity and inferior respiratory tract (Table 3, detection rates of microbial pathogens before and after oral nursing care were listed) |
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| Notes | Diagnosis of VAP was mainly determined by microbial examination of the aspirate secretions from the inferior respiratory tract, which was performed every day | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | "randomly divided into 2 groups" |
| Allocation concealment (selection bias) | Unclear risk | Not specified |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Blinding not described and unclear whether Yikou and saline had the same appearance and odour |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not specified |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | The main results were all reported |
| Selective reporting (reporting bias) | Low risk | The results were fully reported |
| Other bias | Unclear risk | Only the results of microbial examination of the aspirate secretions from the inferior respiratory tract as tool of VAP diagnosis was mentioned and its diagnostic efficacy may not be enough |
APACHE II = Acute Physiology and Chronic Health Evaluation II; CAO = caries/absent/occluded; CDC = Centers for Disease Control; CHX = chlorhexidine; CPIS = Clinical Pulmonary Infection Score; DMFT = decayed/missing/filled teeth; ED = emergency department; ICU = intensive care unit; INR = international normalised ratio; IQRs = interquartile ranges; ITT = intention‐to‐treat; M/F = male/female; PICU = paediatric intensive care unit; ppm = parts per million; RCT = randomised controlled trial; RTI = respiratory tract infection; SAPS = Simplified Acute Physiologic Score; SD = standard deviation; SLS = sodium lauryl sulfate; TRISS = Trauma Injury Severity Score; UTI = urinary tract infection; VAP = ventilator‐associated pneumonia