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Archives of Academic Emergency Medicine

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Vol. 11 No. 1 (2023)

November 2022

Effect of Oral Care with Povidone-Iodine in the Prevention of Ventilator-Associated Pneumonia; a Systematic Review and Meta-Analysis

  • Amir Emami Zeydi
  • Arman Parvizi
  • Soudabeh Haddadi
  • Samad Karkhah
  • Seyed Javad Hosseini
  • Amirabbas Mollaei
  • Mahbobeh Firooz
  • Shahin Ramezani
  • Joseph Osuji
  • Pooyan Ghorbani Vajargah
  • Shadi Dehghanzadeh

Archives of Academic Emergency Medicine, Vol. 11 No. 1 (2023), 15 November 2022 , Page e31
https://doi.org/10.22037/aaem.v11i1.1874 Published: 2023-04-04

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Abstract

Introduction: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections affecting one-third of patients with mechanical ventilation. This study aimed to synthesize available evidence regarding the effect of treatment with povidone-iodine (PI) among adult patients admitted to intensive care units (ICUs) for the prevention of VAP.

Methods: An extensive search was conducted in online databases, including PubMed, Web of Science and Scopus, from the earliest records until January 1, 2023. STATA software v14 was used for statistical analysis. Publication bias was assessed via funnel plot, Begg's and Egger's tests. A P-value less than 0.1 was considered statistically significant for publication bias value.

Results: Four studies were included in the meta-analysis. Three studies showed rhat PI decreased  VAP compared to the placebo group, but it was not statistically significant (RR: 0.61, 95%CI: 0.25 to 1.47, Z=1.10, P=0.27, I2:71.5%). One study compared the effect of PI with chlorhexidine on the rate of VAP, the difference between which was not statistically significant (RR: 1.50, 95%CI: 0.46 to 4.87, Z=0.67, P=0.50, I2:0). Two studies demonstrated that the use of PI intervention compared to placebo decreased the average length of stay in ICU; however, it was not statistically significant (WMD: -0.35, 95%CI:-3.90 to 3.20, Z=0.19, P=0.85, I2:0). Also, three studies showed that using PI had almost no effect on mortality rate compared to placebo (RR: 1.05, 95%CI: 0.66 to 1.53, Z=0.8, P=0.27, I2:29.0%).Conclusion: More rigorously designed randomized clinical trials and further evidence are required to make a better decision/comparison about using PI as a suitable choice for preventing VAP among adult patients admitted to the ICU.

Keywords:
  • Oral hygiene
  • pneumonia, ventilator-associated
  • primary prevention
  • povidone-iodine
  • meta-analysis
  • pdf

How to Cite

1.
Emami Zeydi A, Parvizi A, Haddadi S, Karkhah S, Hosseini SJ, Mollaei A, Firooz M, Ramezani S, Osuji J, Ghorbani Vajargah P, Dehghanzadeh S. Effect of Oral Care with Povidone-Iodine in the Prevention of Ventilator-Associated Pneumonia; a Systematic Review and Meta-Analysis . Arch Acad Emerg Med [Internet]. 2023 Apr. 4 [cited 2025 May 16];11(1):e31. Available from: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1874
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