Evidence map›Paper›PMID 26932921›Full record

ArticleAmerican journal of critical care : an official publication, American Association of Critical-Care Nurses2016

No Decrease in Early Ventilator-Associated Pneumonia After Early Use of Chlorhexidine.

Terrence Wong, Adam B Schlichting, Andrew J Stoltze, Brian M Fuller, Amanda Peacock, Kari K Harland, Azeemuddin Ahmed, Nicholas Mohr

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Article in American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 11 citations in OpenAlex.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Terrence WongTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.
Adam B SchlichtingTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. adam-schlichting@uiowa.edu.
Andrew J StoltzeTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.
Brian M FullerTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.
Amanda PeacockTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.
Kari K HarlandTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.
Azeemuddin AhmedTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.
Nicholas MohrTerrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.
University of Iowa · US

Funding

Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
Washington University Institute of Clinical and Translational SciencesKL2TR000450 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$8.8M
NCATS NIH HHS KL2 TR000450NCATS NIH HHS UL1 TR000448
6 · The paper itself

Abstract

backgroundOral chlorhexidine prophylaxis can decrease occurrence of ventilator-associated pneumonia. However, the importance of timing has never been fully explored.

objectiveTo see if early administration of oral chlorhexidine is associated with lower incidence of early ventilator-associated pneumonia (within 5 days of admission to intensive care unit) in intubated air ambulance patients.

methodsA single-center, retrospective cohort study of intubated adults transported by a university-based air ambulance service and admitted to a surgical intensive care unit from July 2011 through April 2013. Primary exposure was time from helicopter retrieval to the first dose of oral chlorhexidine in the intensive care unit. Early chlorhexidine was defined as receipt of the drug within 6 hours of helicopter departure. The primary outcome was clinical diagnosis of early ventilator-associated pneumonia. Patients who were less than 18 years old, died within 72 hours of admission, or had pneumonia at admission were excluded.

resultsAmong 134 patients, 49% were treated with chlorhexidine before 6 hours, 84% were treated before 12 hours, and 11% were treated for early pneumonia. Early chlorhexidine (before 6 hours; 15%) was not associated (P = .21) with early pneumonia (8%). Furthermore, median times to chlorhexidine did not differ significantly (P = .23) between patients in whom pneumonia developed (5.2 hours) and patients with no pneumonia (6.1 hours).

conclusionsEarly administration of oral chlorhexidine in intubated patients was not associated with a reduction in the incidence of ventilator-associated pneumonia in a surgical intensive care unit with high rates of chlorhexidine administration before 12 hours.

Indexed as

Administration, OralAir AmbulancesAnti-Infective Agents, LocalChlorhexidineCohort StudiesCritical CareFemaleHumansIntensive Care UnitsIntubation, IntratrachealMaleMiddle AgedPneumonia, Ventilator-AssociatedRetrospective StudiesTime FactorsAnti-Infective Agents, LocalChlorhexidine

Identifiers

PMID26932921
PMCPMC5301802
OpenAlexW2306349985

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.