PERBEDAAN KEJADIAN VENTILATOR ASSOCIATE PNEUMONIA PADA ORAL HYGIENE MENGGUNAKAN CHLORHEXIDINE GLUCONATE 0,12% DAN LISTERINE

Abstrak

ABSTRAK

Ventilator Associated Pneumonia (VAP) adalah nosokomial pneumonia yang paling sering ditemui di unit perawatan intensif, khususnya pada pasien yang menggunakan ventilasi mekanik selama 48 jam. Kejadian VAP cukup tinggi, bervariasi antara 10–25% dan angka kematiannya berkisar  10-40%,  serta bisa mencapai 76% pada pasien yang menggunakan ventilasi mekanik yang disebabkan oleh kuman patogen dan penumpukan sekret di trakea. Memberikan oral hygiene, dapat mengurangi kejadian VAP. Tujuan penelitian untuk mengetahui perbedaan pengaruh oral hygiene yang menggunakan chlorhexidine gluconate 0,12% dengan listerine terhadap kejadian VAP di ruang perawatan intensif. Penelitian dilakukan di ruang perawatan intensif  RS Dr. Hasan Sadikin Bandung. Jenis penelitian uji klinis dengan disain Non randomized Concurrent Control Trial. Sampel adalah pasien kritis yang terpasang ventilasi mekanik (ventilator) dan terintubasi. Cara pengambilan sampel  menggunakan cara consecutive sampling, Jumlah sampel kelompok chlorhexidine gluconate 0,12%   dan listerine masing-masing 20 orang. Data kejadian VAP dikumpulkan setelah 48 jam (pada hari ketiga) perawatan melalui daftar checklist pemeriksaan yang menggunakan Clinical Pulmonary Infection Score (CPIS). Mengetahui perbedaan pengaruh oral hygiene yang menggunakan chlorhexidine gluconate 0,12% dengan listerine terhadap kejadian VAP digunakan Chi Square Test. Hasil; Kejadian Ventilator Associated Pneumonia (VAP) pada sampel yang menggunakan oral hygiene chlorhexidine glukonate 0,12% sebanyak 3 orang (15%). Sedangkan yang tidak mengalami VAP sebanyak 17 orang (85%). Kejadian Ventilator Associated Pneumonia (VAP) pada sampel yang menggunakan oral hygiene listerine sebanyak 13 orang (65%), sedangkan yang tidak mengalami VAP sebanyak 7 orang (35%). Kejadian VAP pada kelompok perlakuan yang menggunakan chlorhexidine gluconate 0,12% lebih rendah jika dibandingkan dengan kelompok listerine.

Kata Kunci : Chlorhexidine gluconate 0.12%,  Listerine, Oral hygiene, Ventilator Associated Pneumonia (VAP)

ABSTRACT

Ventilator Associated Pneumonia (VAP) is a nosocomial pneumonia is the most frequently encountered in intensive care units, particularly in patients using mechanical ventilation for 48 hours. VAP incidence is quite high, varying between 10-25% and mortality ranges from 10-40%, and can reach 76% in patients using mechanical ventilation caused by pathogenic bacteria and accumulation of secretions in trachea, Provide oral hygiene, can reduce the incidence of VAP. Research purposes to determine the difference effect of oral hygiene using a 0.12% chlorhexidine gluconate with listerine on the incidence of VAP in intensive care. The study was conducted in intensive care RS. Dr. Hasan Sadikin Bandung. This type of research design with a nonrandomized clinical trials Concurrent Control Trial. The sample is mounted in critically ill patients mechanically ventilated (ventilator). Method of sampling using consecutive sampling. The number of sample groups of chlorhexidine gluconate and 0.12% respectively listerine 20. VAP incidence data were collected after 48 hours (third day) treatment through the list of inspection checklist using the Clinical Pulmonary Infection Score (CPIS). Knowing the difference in the influence of oral hygiene using a 0.12% chlorhexidine gluconate with listerine on the incidence of VAP used Chi Square Test. Result. Incidence of Ventilator Associated Pneumonia (VAP) in the sample using the oral hygiene as much as 0.12% chlorhexidine glukonate 3 people (15.0%). While that does not have as many as 17 people VAP (85.0%). Incidence of Ventilator Associated Pneumonia (VAP) in the sample using listerine oral hygiene as much as 13 people (65.0%), while VAP who did not experience as many as 7 people (35.0%). Incidence of VAP in the group treated using chlorhexidine gluconate 0.12% lower when compared with the listerine group.

Keywords : Chlorhexidine gluconate 0.12%, Listerine, Oral hygiene, Ventilator Associated Pneumonia (VAP)