Carlos Fernando de Almeida Barros Mourão, Rafael Coutinho de Mello-Machado, Vittorio Moraschini, Monica Diuana Calasans-Maia
Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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|Date of Submission||16-Apr-2020|
|Date of Acceptance||28-Apr-2020|
|Date of Web Publication||05-Jun-2020|
The present note aims to alert the importance of oral healthcare in patients under mechanical ventilation by COVID-19. Patients hospitalized for long periods and needing the support of mechanical ventilators are susceptible to secondary infections. Thereby, many patients may have already died from infections, secondary to pneumonia caused by COVID-19.
Keywords: Coronavirus, COVID-19, intubation, oral care, pneumonia
|How to cite this URL:|
Mourão CF, Mello-Machado RC, Moraschini V, Calasans-Maia MD. Ventilator-associated pneumonia and SARS-CoV-2 (COVID-19): An invisible risk for patients. Int J Growth Factors Stem Cells Dent [Epub ahead of print] [cited 2020 Nov 30]. Available from: https://www.cellsindentistry.org/preprintarticle.asp?id=286097
The use of ventilators during the process of treating patients with acute respiratory syndrome caused by coronavirus (COVID-19) is a process that aims to maintain proper oxygen saturation in the body, in addition to relieving symptoms of respiratory effort.
This process performed by the patient's intubation is essential for the patient's recovery. However, some people affected by COVID-19, especially the elderly and those considered to be at risk, such as diabetics, cardiac patients, and immunosuppressed patients, may need longer recovery time. The increase in the time of intubation of these patients can cause secondary respiratory infections as is the case of nosocomial pneumonia.
Patients hospitalized for long periods and needing the support of mechanical ventilators are susceptible to these secondary infections, most often caused by the bacteria from the biofilm present in the oral cavity. Care is required in cleaning the tubes and the oral cavity.
However, most of the time, cleaning the tubes is the competence of the nursing team, which is usually overwhelmed by the number of patients. Further, the most suitable professional to perform this procedure is a dentist as it presents the knowledge of cleaning and maintenance of oral health to patients.
This issue of secondary infection is why the intubation process causes a more significant accumulation of bacteria in the oral cavity, due to decrease in the salivary flow, as the patient will keep his/her mouth open for an extended period leaving his/her mouth dry. These bacteria in a healthy body are a health risk. However, in these hospitalized patients, who are recovering from pneumonia caused by a virus, they may suffer an aggravation of the case due to extended stay on the mechanical ventilator.
As a result, many patients may have already died from infections, secondary to pneumonia caused by COVID-19. Usually, there is no presence of dental surgeons in the intensive care units to perform the necessary care to maintain oral health, washing, and aspiration of the inpatient's tube.
These simple procedures, for a competent professional, can save many lives. That is why, we wrote this short communication as a form of alert for health professionals and the scientific community.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al
. Risk factors of critical and mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect 2020;doi:10.1016/j.jinf.2020.04.021.
Esperatti M, Ferrer M, Theessen A, Liapikou A, Valencia M, Saucedo LM, et al
. Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients. Am J Respir Crit Care Med 2010;182:1533-9.
McCue MK, Palmer GA. Use of chlorhexidine to prevent ventilator associated pneumonia in a long-term care setting: A retrospective medical record review. J Nurs Care Qual 2019;34:263-8.
Carlos Fernando de Almeida Barros Mourão,
Department of Oral Surgery, Dentistry School, Fluminense Federal University, R. Mario Santos Braga, 30 - Niterói, Rio de Janeiro
Source of Support: None, Conflict of Interest: None