Evidence map›Paper›PMID 41456054›Full record

Trial reportBMC oral health2025

Effect of chlorhexidine vs. saline for oral care on oral microbiota and prognosis of elderly mechanically ventilated patients in the intensive care unit: a single-center, single-blind, randomized controlled trial.

Changcui Qiu, Lulu Tang, Zhuo Hang, Ke Wei, Sheng Wang, Xiaoping Zhu, Qixing Wang

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06691841 (Effect of Chlorhexidine Gluconate in Oral Care of Patients With Endotracheal Intubation Based on 16sRNA Technology), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

NCT06691841 nacompletednot on this map

Effect of Chlorhexidine Gluconate in Oral Care of Patients With Endotracheal Intubation Based on 16sRNA Technology

TypeinterventionalSponsorShanghai 10th People's HospitalRan2022 to 2024Enrolled76ConditionsIntubation, Endotracheal, Oral HygieneArmsChlorhexidine Gluconate, normal saline
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
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

7 authors.

Changcui QiuSchool of Medicine, Tongji University, Shanghai, China.
Lulu TangSchool of Medicine, Tongji University, Shanghai, China.
Zhuo HangSchool of Medicine, Tongji University, Shanghai, China.
Ke WeiSchool of Medicine, Tongji University, Shanghai, China.
Sheng WangDepartment of Critical Care Medicine, Tongji Hospital, Shanghai, China.
Xiaoping ZhuDepartment of Nursing, Shanghai Tenth People's Hospital, Shanghai, China. qiuyanjiusheng@126.com.
Qixing WangDepartment of Critical Care Medicine, Shanghai Tenth People's Hospital, Shanghai, China. wangqixing1221@tongji.edu.cn.

Funding

National Natural Science Foundation of China 72074168
6 · The paper itself

Abstract

backgroundThe role of chlorhexidine in oral care for mechanically ventilated elderly patients remains debated, particularly regarding its impact on oral microbiota and clinical outcomes.

objectiveTo compare oral microbiota composition and prognosis among elderly mechanically ventilated patients receiving oral care with either chlorhexidine solution or normal saline.

methodsSixty intubated patients (≥ 65 years) were randomized to receive oral care with 0.12% chlorhexidine (intervention group) or 0.9% saline (control group) three times daily during mechanical ventilation. All patients underwent standardized oral hygiene during mechanical ventilation. Oral samples were analyzed by 16 S rRNA sequencing, with outcomes compared to oral health and clinical data. Secondary outcomes included dental plaque index, ventilator-associated pneumonia (VAP), 28-day mortality, patient outcomes, and oral complications.

resultsOne week after intervention, the chlorhexidine group exhibited a significant decrease in oral bacterial diversity (Simpson index, P = 0.037). Despite this, no significant differences were observed in clinical infection symptoms-defined as fever, purulent airway secretions, elevated white blood cell count, or increased C-reactive protein levels requiring evaluation by the attending physician. All participants received standard ICU antimicrobial prophylaxis or therapy according to institutional protocols; no additional systemic antibiotics were initiated solely for oral or respiratory infections. There were no significant differences between groups in ventilator-associated pneumonia (VAP) incidence (P = 1.000), duration of mechanical ventilation (P = 0.063), ICU stay (P = 0.191), 28-day mortality (P = 0.82), or rates of complications and plaque formation. The chlorhexidine group also showed a decrease in dominant microbial taxa and an increase in specific anaerobic bacteria.

conclusionChlorhexidine temporarily altered oral microbiota composition without improving short-term clinical outcomes. Although no infections increased, its potential impact on microbial balance warrants caution, and larger studies are needed to validate these findings.

trial registrationClinicalTrials.gov ID NCT06691841. Registeration Date 23 September 2022, https://clinicaltrials.gov/study/NCT06691841 .

Indexed as

Anti-Infective Agents, LocalChlorhexidineMicrobiotaMouthOral HygieneRespiration, ArtificialSaline SolutionAgedAged, 80 and overFemaleHumansIntensive Care UnitsMalePneumonia, Ventilator-AssociatedPrognosisSingle-Blind MethodAnti-Infective Agents, LocalChlorhexidineSaline SolutionChlorhexidineIntensive care unitsMicrobiotaOral hygieneVentilator-Associated pneumonia

Identifiers

PMID41456054
PMCPMC12859887

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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.