Effect of oral cleaning with traditional Chinese medicine preparations on hospital-acquired pneumonia in patients undergoing non-invasive mechanical ventilation

OBJECTIVE To explore the effect of oral cleaning with traditional Chinese medicine preparations on decolonization of oropharyngeal bacteria and hospital-acquired pneumonia (HAP) in elderly patients undergoing non-invasive mechanical ventilation.

METHODS A total of 520 elderly patients who were treated with non-invasive mechanical ventilation in Enze Hospital of Enze Medical Center (Group) from Jan. 2022 to Dec. 2024 were recruited as the research subjects and were randomly divided into the normal saline group and the traditional Chinese medicine (TCM) preparation group, with 260 cases in each group. The two groups were respectively treated with normal saline and TCM preparations for oral cleaning, twice a day in the morning and evening. The dental plaque index score, isolation rate of oropharyngeal pathogens, incidence of HAP and isolation rates of pathogens causing HAP were observed and compared between the two groups.

RESULTS There were no significant differences in the dental plaque index score and the isolation rate of oropharyngeal pathogens between the two groups of patients before the first cleaning. However, the dental plaque index score and the isolation rate of oropharyngeal pathogens were lower in the TCM preparation group than in the normal saline group after the first cleaning and the continuous cleaning for 5 days (P < 0.05). The incidence of HAP of the TCM preparation group (3.63%) was lower than that of the normal saline group (8.91%) (χ ²=5.872, P=0.015). The isolation rate of gram-negative bacteria from lower respiratory tract secretions of the patients with HAP was lower in the TCM preparation group than in the normal saline group (P < 0.05); there were no significant differences in the isolation rates of gram-positive bacteria and fungi between the two groups.

CONCLUSION As compared with the normal saline for routine oral cleaning of the elderly patients undergoing non-invasive mechanical ventilation, the TCM preparations may facilitate the decolonization of oropharyngeal bacteria and remarkably reduce the incidence of HAP, which may provide a new idea for decolonization of oropharyngeal bacteria and reduction of incidence of HAP.