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Salud bucal en pacientes en estado crítico
Resumen
Fundamento: La salud bucal y sus cuidados son importantes en la atención sanitaria de pacientes en estado crítico.
Objetivo: Proporcionar una visión general de los vínculos entre la salud bucal y los resultados adversos en la evolución de los pacientes en estado crítico.
Metodología: Esta revisión narrativa se realizó en Google Académico, PubMed/Medline y SciELO, con los descriptores salud bucal, cuidados críticos, respiración artificial y neumonía asociada al ventilador, consultados en el DeCS. Se seleccionaron artículos a texto completo en español e inglés de revistas arbitradas por pares y de los últimos 5 años.
Resultados: La disbiosis y la mala higiene bucales propician la aparición y desarrollo de enfermedades bucales que, a su vez, favorecen la incidencia de enfermedades respiratorias bajas como la neumonía asociada al ventilador en pacientes en estado crítico. Dentro de los factores vinculantes están la aspiración de secreciones bucales con bacterias patógenas que colonizan el tracto respiratorio inferior y los trastornos nutricionales que reducen el sistema defensivo. Aunque existen algunas discrepancias, la mayoría de los estudios apoyan las medidas de cuidado bucal en los pacientes en estado crítico.
Conclusiones: La salud y cuidados bucales son claves para un desenlace clínico más favorable en los pacientes en estado crítico.Palabras clave
Referencias
Winning L, Lundy FT, Blackwood B, McAuley DF, El Karim I. Oral health care for the critically ill: a narrative review. Crit Care [Internet]. 2021 [cited 2022 Dec 25];25(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485109/pdf/13054_2021_Article_3765.pdf
Takahama A Jr, de Sousa VI, Tanaka EE, Ono E, Ito FAN, Costa PP, et al. Analysis of oral risk factors for ventilator-associated pneumonia in critically ill patients. Clin Oral Investig [Internet] 2021 [cited 2022 Dec 25];25(3):217-1222. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320842/pdf/784_2020_Article_3426.pdf
Martínez M, Postolache TT, García-Bueno B, Leza JC, Figuero E, Lowry CA, et al. The Role of the Oral Microbiota Related to Periodontal Diseases in Anxiety, Mood and Trauma- and Stress-Related Disorders. Front Psychiatry [Internet] 2022 [cited 2022 Dec 30];12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833739/pdf/fpsyt-12-814177.pdf
Nomura Y, Ishii Y, Suzuki S, Morita K, Suzuki A, Suzuki S, et al. Nutritional Status and Oral Frailty: A Community Based Study. Nutrients [Internet]. 2020 [cited 2022 Dec 25];12(9) Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551233/pdf/nutrients-12-02886.pdf
Sánchez-Peña MK, Orozco-Restrepo LA, Suárez-Brochero ÓF, Barrios-Arroyave FA. Association between oral health, pneumonia and mortality in patients of intensive care. Rev Med Inst Mex Seguro Soc [Internet] 2020 [cited 2022 Dec 25];58(4):468-476. Available from: http://revistamedica.imss.gob.mx/editorial/index.php/revista_medica/article/view/3625/4105
Muramatsu K, Matsuo K, Kawai Y, Yamamoto T, Hara Y, Shimomura Y, et al. Comparison of wiping and rinsing techniques after oral care procedures in critically ill patients during endotracheal intubation and after extubation: A prospective cross-over trial. Jpn J Nurs Sci [Internet]. 2019 [cited 2022 Dec 25];16(1):80-87. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jjns.12217 https://doi.org/10.1111/jjns.12217
Sato S, Takahashi H. Assessment of the risk of malnutrition due to aspiration pneumonia and oral feeding difficulty. Nutr Hosp [Internet]. 2020 [cited 2022 Dec30];37(4):723-729. Available from: https://pubmed.ncbi.nlm.nih.gov/32720506/ https://doi.org/10.20960/nh.03109
Vieira PC, de Oliveira RB, da Silva Mendonça TM. Should oral chlorhexidine remain in ventilator-associated pneumonia prevention bundles? Med Intensiva [Internet]. 2022 [cited 2022 Dec 30];46(5):259-268. Available from: https://www.sciencedirect.com/science/article/abs/pii/S2173572722000637?via%3Dihub https://doi.org/10.1016/j.medine.2020.09.010
Haghighi A, Shafipour V, Bagheri-Nesami M, Gholipour Baradari A, Yazdani Charati J. The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients. Aust Crit Care [Internet]. 2017 [cited 2022 Ene 25];30(2):69-73. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1036731416300649?via%3Dihub https://doi.org/10.1016/j.aucc.2016.07.002
Bellissimo-Rodrigues WT, Menegueti MG, de Macedo LD, Basile-Filho A, Martinez R, Bellissimo-Rodrigues F. Oral mucositis as a pathway for fatal outcome among critically ill patients exposed to chlorhexidine: post hoc analysis of a randomized clinical trial. Crit Care [Internet]. 2019 [cited 2022 Dec 25];23(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882234/pdf/13054_2019_Article_2664.pdf https://doi.org/10.1186/s13054-019-2664-6
Collins T, Plowright C, Gibson V, Stayt L, Clarke S, Caisley J, et al. British Association of Critical Care Nurses: Evidence-based consensus paper for oral care within adult critical care units. Nurs Crit Care [Internet]. 2021[cited 2022 Dec30];26(4):224-233. Available from: https://pubmed.ncbi.nlm.nih.gov/33124119/
Cruz JC, Martins CK, Piassi JEV, Garcia Júnior IR, Santiago Junior JF, Faverani LP. Does chlorhexidine reduce the incidence of ventilator-associated pneumonia in ICU patients? A systematic review and meta-analysis. Med Intensiva (Engl Ed) [Internet]. 2022 [cited 2022 Dec 30];S2173-5727(22). Available from: https://www.sciencedirect.com/science/article/abs/pii/S2173572722003290?via%3Dihub
Saensom D, Merchant AT, Wara-Aswapati N, Ruaisungnoen W, Pitiphat W. Oral health and ventilator-associated pneumonia among critically ill patients: a prospective study. Oral Dis [Internet]. 2016 [cited 2022 Dec 25];22(7):709-714. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1111/odi.12535
Munro CL, Grap MJ, Elswick RK Jr, McKinney J, Sessler CN, Hummel RS. Oral health status and development of ventilator-associated pneumonia: a descriptive study. Am J Crit Care [Internet]. 2006 [cited 2022 Dec 25];15(5):453-460. Available from: https://pubmed.ncbi.nlm.nih.gov/16926366
Moosavi MS, Aminishakib P, Ansari M. Antiviral mouthwashes: possible benefit for COVID-19 with evidence-based approach. J Oral Microbiol [Internet]. 2020 [cited 2022 Dec 30];12(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482897/pdf/ZJOM_12_1794363.pdf
Choi MI, Han SY, Jeon HS, Choi ES, Won SE, Lee YJ, et al. The Effect of Professional Oral Care on the Oral Health Status of Critical Trauma Patients Using Ventilators. Int J Environ Res Public Health [Internet]. 2022 [cited 2022 Dec 30];19(10). Available from: https://www.mdpi.com/1660-4601/19/10/6197
Liao YM, Tsai JR, Chou FH. The effectiveness of an oral health care program for preventing ventilator-associated pneumonia. Nurs Crit Care [Internet]. 2015 [cited 2022 Dec 25];20(2):89-97. Available from: https://onlinelibrary.wiley.com/doi/10.1111/nicc.12037
Sánchez-Sánchez R, Sigcho-Romero C, Teruel-Ginés R, Tamayo-Ortíz B. Una asociación peligrosa: COVID-19 y enfermedad periodontal. CCM [Internet]. 2022 [citado 30 Dic 2022];26(2) Disponible en: https://revcocmed.sld.cu/index.php/cocmed/article/view/4401
Sánchez Sánchez RJ, Sigcho Romero CR, Niño Peña A. Una díada de riesgo: periodontitis y COVID-19. Gac Méd Espirit [Internet]. 2022 [citado 30 Dic 2022];24(2):1-15. Disponible en: http://scielo.sld.cu/pdf/gme/v24n2/1608-8921-gme-24-02-2420.pdf
Cantón-Bulnes ML, Garnacho-Montero J. Antisepsia orofaríngea en el paciente crítico y en el paciente sometido a ventilación mecánica. Medicina Intensiva [Internet]. 2019 [citado 25 Dic 2022];43(Supl1):23-30. Disponible en: https://medintensiva.org/es-pdf-S0210569118302559
Antalová N, Klučka J, Říhová M, Poláčková S, Pokorná A, Štourač P. Ventilator-Associated Pneumonia Prevention in Pediatric Patients: Narrative Review. Children (Basel) [Internet]. 2022 Oct 9;9(10). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600673/pdf/children-09-01540.pdf
Melchior LMR, Santos ER, Carvalho BDP, Margarida MCA, Pereira TLCS, Paulo GML, et al. Treinamento de higiene oral em paciente crítico. R Rev. enferm. UFPE on line [Internet]. 2021 [cited 2022 Dec 25];15(1):1-9. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/245930/37550#
Jackson L, Owens M. Does oral care with chlorhexidine reduce ventilator-associated pneumonia in mechanically ventilated adults? Br J Nurs [Internet]. 2019 [cited 2022 Dec 25];28(11):682-689. Available from: https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2019.28.11.682?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
Humeres-Sigala C, Márquez A, González-Ritchie P, Valenzuela-Ramos R, Rivera-Saavedra M, Vásquez P, et al. Manejo Multidisciplinario de la Cavidad Oral en Pacientes COVID-19 bajo Ventilación Mecánica Invasiva. Rol del Equipo Odontológico. Int J Odontostomat [Internet]. 2020 Dic [citado 30 Dic 2022];14(4):701-704. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0718-381X2020000400701&lng=es
Álvarez Lerma F, Sánchez García M, Lorente L, Gordo F, Añón JM, Álvarez J,. Guidelines for the prevention of ventilator-associated pneumonia and their implementation. The Spanish "Zero-VAP" bundle. Med Intensiva [Internet]. 2014 [cited 2022 Dec 30];38(4):226-36. Available from: https://www.medintensiva.org/en-guidelines-for-prevention-ventilator-associated-pneumonia-articulo-S217357271400023X
Rivera-Ramos ES. La importancia del OHIP (Oral Health Impact Profile) en la Odontología. Odontol. Sanmarquina [Internet]. 2020 [cited 25 Dic 2022]; 23(1): 35-42 Disponible en: https://docs.bvsalud.org/biblioref/2020/03/1053509/17505-texto-del-articulo-60948-1-10-20200221.pdf
de Camargo L, da Silva SN, Chambrone L. Efficacy of toothbrushing procedures performed in intensive care units in reducing the risk of ventilator-associated pneumonia: A systematic review. J Periodontal Res [Internet]. 2019 [cited 2022 Dec 25];54(6):601-611. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jre.12668
Zhao T, Wu X, Zhang Q, Li C, Worthington HV, Hua F. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev [Internet]. 2020 [cited 2022 Dec 25];12(12). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460950/pdf/CD008367.pdf
Lee S, Lighvan NL, McCredie V, Pechlivanoglou P, Krahn M, Quiñonez C, et al. Chlorhexidine-Related Mortality Rate in Critically Ill Subjects in Intensive Care Units: A Systematic Review and Meta-Analysis. Respir Care [Internet]. 2019 [cited 2022 Dec 25];64(3):337-349. Available from: https://rc.rcjournal.com/content/64/3/337/tab-pdf
Hua F, Xie H, Worthington HV, Furness S, Zhang Q, Li C. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev [Internet]. 2016 [cited 2022 Dec 25];10(10). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460950/pdf/CD008367.pdf
Moreno Sancho F, Tsakos G, Brealey D, Boniface D, Needleman I. Development of a tool to assess oral health-related quality of life in patients hospitalised in critical care. Qual Life Res [Internet]. 2020 [cited 2022 Dec 30];29(2):559-568. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994456/pdf/11136_2019_Article_2335.pdf
Marouf N, Cai W, Said KN, Daas H, Diab H, Chinta VR, et al. Association between periodontitis and severity of COVID-19 infection: A case-control study. J Clin Periodontol. 2021 Apr;48(4):483-491. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014679/pdf/JCPE-48-483.pdf
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