Perbedaan Efektivitas Iodine Povidone 1% dengan Listerine® sebagai Preparat Perawatan Mulut terhadap Pencegahan Ventilator Associated Pneumonia

Ardana Tri Arianto, Bambang Novianto Putro, Indra Chuandy

Abstract


Perawatan mulut merupakan salah satu cara mencegah ventilator associated pneumonia (VAP) pada pasien yang menggunakan ventilasi mekanik. Penelitian ini bertujuan mengetahui prevalensi VAP dan efektivitas preparat antiseptik pada perawatan mulut pasien terintubasi terhadap pencegahan VAP. Penelitian menggunakan uji klinis acak tersamar tunggal pada 36 pasien dengan ventilasi mekanik pasien yang dirawat di ICU RS Dr. Moewardi bulan Februari–Mei 2017. Sampel dibagi menjadi 2 kelompok, yaitu kelompok iodine povidone 1% dan Listerine®. Awalnya dilakukan penilaian kebersihan mulut dengan simplified oral hygiene index. Setelahnya, dilakukan perawatan mulut menggunakan salah satu preparat. Setelah 48 jam, dilakukan penilaian ulang kebersihan mulut dan skor clinical pulmonary indicator score (CPIS). Timbul VAP bila skor CPIS ≥6. Data dianalisis dengan uji Mann Whitney dan independetn t-test. Kelompok iodine povidone 1% memiliki perubahan skor kebersihan mulut dengan selisih yang lebih kecil (0,195) dibanding dengan Listerine® (0,3605). Hal ini menunjukkan bahwa Listerine® lebih efektif menjaga kebersihan mulut (p=0,024). Listerine® secara signifikan lebih efektif dalam mencegah VAP bila dibanding dengan iodine povidone 1% (p=0,001). Tidak ada perbedaan signifikan pada subjek yang meninggal akibat VAP positif dengan negatif (p=0,280). l Simpulan listerine® memiliki efektivitas lebih tinggi mencegah VAP dibanding dengan iodine povidone 1%.


Differences in Effectiveness of Iodine Povidone 1% and Listerine® as Oral Care Preparations in Preventing Ventilator-Associated Pneumonia


Oral care is one way to prevent VAP in patients using mechanical ventilation. x This study aimed to determine the prevalence of VAP and the effectiveness of antiseptic preparations in the oral care of intubated patients to prevent ventilator associated pneumonia (VAP). The study used a randomized, single-blind clinical trial in 36 mechanically ventilated patients admitted to the ICU of Dr. Moewardi in February –May 2017. The samples were divided into two groups, namely the 1% povidone-iodine group and Listerine®. Initially, oral hygiene was assessed using the simplified oral hygiene index. After that, oral care was performed using one of the preparations. After 48 hours, oral hygiene and clinical pulmonaryindicator score (CPIS) scores were reassessed. VAP occurred when the CPIS score was 6. The Mann-Whitney test and independent t-test analyzed the data. The 1% povidone-iodine group changed oral hygiene scores with a minor difference (0.195) than Listerine® (0.3605). It indicated that Listerine® was more effective in maintaining oral hygiene (p=0.024). Listerine® was significantly more effective in preventing VAP when compared with 1% iodine povidone (p=0.001). There was no significant difference in mortality of VAP positive or negative subjects (p=0.280). In conclusion, the use of Listerine® as an oral care preparation is significantly more effective in preventing VAP compared to 1% iodine povidone.


Keywords


Iodine povidone 1%, kebersihan mulut, listerine®, VAP

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DOI: https://doi.org/10.15851/jap.v9n3.2434

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