Table 1.

Recommended research to investigate potential chlorhexidine-related adverse outcomes

Research area	Outcomes	Suggested approach
Mortality	ICU mortality	Randomized control trials
Mucosal adverse events	Oral mucosal lesions; dose response; patient predictors of oral lesions; sepsis; mortality	Prospective observational studies; controlled trials; validated oral health indexes
Pulmonary adverse events	Acute respiratory distress syndrome (ARDS); ventilator-associated events (VAEs); duration of mechanical ventilation	Retrospective and prospective observational studies
Bacterial resistance	Bacterial resistance; infection-related ventilator-associated complications (IVACs); sepsis	Antimicrobial sensitivity testing
Patient experience	Behavioral pain scores; patient self-report of pain, dry mouth, bad taste	Prospective observational studies; qualitative studies