Evidence map›Paper›PMID 28830529›Full record

Trial reportTrials2017

Oral hygiene in intensive care unit patients with photodynamic therapy: study protocol for randomised controlled trial.

Gabriela Alves Da Collina, Anna Carolina Ratto Tempestini-Horliana, Daniela de Fátima Teixeira da Silva, Priscila Larcher Longo, Maria Luisa Faria Makabe, Christiane Pavani

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 14% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Oral colonization ofIranian journal of basic medical sciences · 2022
    Article
  5. Article
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

6 authors at 1 institution in 1 country.

Gabriela Alves Da CollinaBiophotonics Applied to Health Sciences Postgraduation Program, Universidade Nove de Julho - UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
Anna Carolina Ratto Tempestini-HorlianaBiophotonics Applied to Health Sciences Postgraduation Program, Universidade Nove de Julho - UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
Daniela de Fátima Teixeira da SilvaBiophotonics Applied to Health Sciences Postgraduation Program, Universidade Nove de Julho - UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
Priscila Larcher LongoBiophotonics Applied to Health Sciences Postgraduation Program, Universidade Nove de Julho - UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
Maria Luisa Faria MakabeSchool of Dentistry, Universidade Nove de Julho - UNINOVE, São Paulo, Brazil.
Christiane PavaniBiophotonics Applied to Health Sciences Postgraduation Program, Universidade Nove de Julho - UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil. chrispavani@gmail.com.ORCID 0000-0001-8275-7370
Universidade Nove de Julho · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn intensive care units (ICUs), nosocomial infections are prevalent conditions and they have been related to high mortality indexes. Some studies have suggested that inefficient oral hygiene and ventilator-associated pneumonia (VAP) are related. Nowadays, in the Brazilian public health system there is no well-defined protocol for oral hygiene in an ICU. Due to the drawbacks of the use of antibiotics, photodynamic therapy (PDT) has emerged as an interesting technique in order to reduce antimicrobial-resistant pathogens. Methylene blue (MB) is the most common chemical agent for PDT in Brazil. However, new formulations for improved effectiveness are still lacking. The objective of this study is to evaluate the use of an MB mouthwash as an effective oral-hygiene procedure in an ICU and to show that oral hygiene using PDT with MB mouthwash may reduce VAP frequency to rates similar to, or higher than, chlorhexidine.

methodsPhase 1 will evaluate the most effective cleaning procedure, while phase 2 will correlate oral hygiene to VAP incidence. At the start of phase 1, the ICU patients will be randomly allocated into three different groups (10 patients/group): the efficacy of chlorhexidine, classical MB-PDT, and mouthwash MB-PDT will all be measured for the quantification of viable bacteria, both pre- and post-treatment, by a Reverse Transcription Polymerase Chain Reaction (RT-PCR). In phase 2, the most effective procedure found in phase 1 and a mechanical cleaning with filtered water will be carried out daily, once a day, over 5 days, with a total of 52 ICU patients randomly allocated into the two groups. The clinical records will be evaluated in order to find any pneumonic diagnoses. DISCUSSION: Since a variety of bacterial species are related to VAP, a universal primer for bacteria will be used in order to quantify the total bacteria count in the participants' samples. In order to quantify only the living bacteria before DNA extraction, the samples will be treated with propidium monoazide. This will infiltrate the dead bacteria and will intercalate the DNA bases, avoiding their DNA amplification. This will be the first trial to evaluate MB-PDT in a mouthwash formula that can increase the effectiveness due to the control of MB aggregation. The results of this study will be able to generate an easy and low-cost protocol to be used in an ICU for the Brazilian public health system.

trial registrationThis protocol was approved by the Research Ethics Committee of the Conjunto Hospitalar do Mandaqui (1.317.834, CAAE: 49273515.9.3001.5551) and it was registered in Registro Brasileiro de Ensaios Clínicos (ReBEC number: RBR-94bvrc;). First received: 12 July 2015; 1st version 6 June 2016. Data will be published in a peer-reviewed journal.

Indexed as

Intensive Care UnitsAdministration, OralBacterial LoadBrazilClinical ProtocolsCross InfectionDouble-Blind MethodHumansMethylene BlueMouthMouthwashesOral HygienePhotochemotherapyPhotosensitizing AgentsPneumonia, BacterialPneumonia, Ventilator-AssociatedMethylene BlueMouthwashesPhotosensitizing AgentsDentistryIntensive care unitsMethylene blue mouthwashNosocomial infectionsPhotodynamic therapy

Identifiers

PMID28830529
PMCPMC5568342
OpenAlexW2745445681

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.