ArticleJournal of anesthesia, analgesia and critical care2024
Chlorhexidine is not effective at any concentration in preventing ventilator-associated pneumonia: a systematic review and network meta-analysis.
Article in Journal of anesthesia, analgesia and critical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Biofilm Formation on Endotracheal and Tracheostomy Tubing: A Systematic Review and Meta-Analysis of Culture Data and Sampling Method.MicrobiologyOpen · 2025Pooled it
- Oral care interventions in adult intensive care unit patients: A systematic review of oral and respiratory outcomes.Journal of Taibah University Medical Sciences · 2026Article
- Oral Health in Hospitalized Adults: Clinical Outcomes and the Role of Dental Expertise.Cureus · 2026Review
- Beyond the Lungs: ICU Oral Care and Gut Resilience-A Hypothesis-Generating Narrative Review.Microorganisms · 2026Review
- Strategies to prevent ventilator-associated pneumonia in critically ill mechanically ventilated patients: a SIAARTI consensus statement.Journal of anesthesia, analgesia and critical care · 2026Review
- Ventilator-Associated Pneumonia (VAP) Prevention Bundle: A Multicenter Cross-Sectional Saudi Study to Assess Knowledge, Adherence, and Perceived Barriers Among ICU Practitioners in Hail Region.Pathogens (Basel, Switzerland) · 2026Article
- A Narrative Review of Oral Hygiene and Pulmonary Health Amid Dysphagia: Implications for Feeding Route, Nutrition, and Quality of Life.Nutrients · 2026Review
- Enhanced Moisture-Focused, Nurse-Led Oral Care Improves Oral Health and Suppresses Bacterial Overgrowth in Mechanically Ventilated ICU Patients: A Quasi-Experimental Study.Nursing in critical care · 2026Article
- Oral Hygiene Interventions and Pneumonia Prevention in Critical Care: An Integrative Review of Evidence and Practice.International journal of dentistry · 2026Review
- Oral hygiene management in critically ill patients: prevention of ventilator-associated pneumonia.Frontiers in dental medicine · 2026Review
- Towards airway microbiome engineering for improving respiratory health.Advanced drug delivery reviews · 2025Review
- 2024 Year in Review: Ventilator-Associated Pneumonia.Respiratory care · 2025Review
- Article
- Effect of oral care protocol with versus without chlorhexidine on mortality of mechanically ventilated patients: Prospective randomized controlled trial.Journal of anaesthesiology, clinical pharmacologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOral chlorhexidine has been widely used for ventilator-associated pneumonia prevention in the critical care setting; however, previous studies and evidence synthesis have generated inconsistent findings. Our study aims to investigate if different concentrations of oral chlorhexidine may be effective in preventing such complication in intensive care unit patients.
methodsAfter pre-registration (Open Science Framework: 8CUKF), we conducted a network meta-analysis with the following PICOS: adult patients (age > 18 years old) undergoing invasive mechanical ventilation admitted in ICU (P); any concentration of chlorhexidine used for oral hygiene (I); placebo, sham intervention, usual care, or no intervention (C); rate of VAP (primary outcome), mechanical ventilation length, ICU length of stay (LOS), hospital LOS, mortality (secondary outcomes) (O); randomized controlled trials (S). We used the following database: PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and EMBASE without any limitation in publication date or language.
resultsChlorhexidine did not demonstrate any significant advantage over the control group in preventing ventilator-associated pneumonia or reducing mortality, duration of mechanical ventilation, length of stay in the intensive care unit, or overall mortality.
conclusionsChlorhexidine oral decontamination does not reduce the rate of ventilator-associated pneumonia in critically ill adult patients and its routine use could not be recommended.
trial registrationRegistration number: Open Science Framework: 8CUKF.
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Registered trials
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.