Comparison the effect of mouth washing with chlorhexidine, sodium bicarbonate and saline on the rate of bacterial colonization of endotracheal tubes and incidence of pneumonia in patients undergoing open heart surgery in Imam Ali Hospital, Kermanshah

Background: Nosocomial pneumonia is the most common type of infection in intensive care units. This study aimed to compare the efficacy of Chlorhexidine mouthwash 0.2%, 1% sodium bicarbonate and normal saline 0.9% on bacterial colonization of endotracheal
tube cuff and the incidence of pneumonia in patients undergoing open heart surgery.
Methods: In this clinical trial study, 165 patients undergoing open heart surgery were enrolled and randomly divided into three groups: Chlorhexidine, sodium bicarbonate and normal saline. In each group twice a day, rinsing with mouthwash was given. To determine bacterial colonization, the tube was removed and the number of colonies was counted. At discharge time, patients were evaluated for pneumonia. Data was analyzed by descriptive and inferential statistics using SPSS-20.
Results: Mean and standard deviation of bacterial colonization in the Chlorhexidine group was 305 × 103 ± 97 × 103 , in the sodium bicarbonate group 330 × 103 ± 110 × 103 and in normal saline Group 358 × 103 ± 104 × 103 . The incidence of pneumonia was 3.6% (2 cases) in Chlorhexidine group, 5.5% (3 cases) in group bicarbonate sodium and 9.1 %( 5 cases) normal saline group.
There were no significant differences among the three groups in term of bacterial colonization and incidence of pneumonia.
Conclusion: Every three mouthwashes, have similar effect in reduction of bacterial accumulation around the tracheal tube cuff and rate of pneumonia too. Therefore mouthwash with each of these solutions in cardiac surgical patients is recommended.