Efektivitas bahan oral care dalam upaya pencegahan ventilator-associated pneumonia (VAP) pada pasien kritis: A systematic review
DOI: https://doi.org/10.33024/hjk.v19i7.1075
Oral Care Pasien Kritis Ventilator-Associated Pneumonia (VAP)
Abstract
Background: The most common nosocomial infection in Intensive Care Unit (ICU) patients on mechanical ventilators is ventilator-associated pneumonia (VAP). One recommended prevention strategy is oral care. However, the effectiveness of various oral care materials in preventing VAP remains unclear.
Purpose: To assess the effectiveness of oral care materials in preventing ventilator-associated pneumonia (VAP) in critically ill patients.
Method: This systematic review followed PRISMA guidelines. Articles were retrieved from PubMed, ScienceDirect, and Google Scholar databases published between 2014 and 2025. Included articles were RCTs or quasi-experimental studies that addressed oral care interventions in ventilator patients. Quality assessment was performed using CASP-JBI.
Results: Based on the 10 articles reviewed, oral care materials used included chlorhexidine, hydrogen peroxide, orthodentol, lactoperoxidase, and probiotics. Oral care techniques included brushing and rinsing, performed two to three times daily. Most studies have shown a reduction in the incidence of VAP in the intervention group.
Conclusion: Oral care is effective in preventing VAP, especially when performed regularly with appropriate techniques and materials. The combination of toothbrushing and antiseptics such as chlorhexidine has been shown to be optimal in reducing the risk of VAP.
Keywords: Critically Patients; Oral Care; Ventilator-Associated Pneumonia (VAP).
Pendahuluan: Infeksi nosokomial yang paling sering terjadi pada pasien di Intensive Care Unit (ICU) yang menggunakan ventilator mekanik adalah ventilator-associated pneumonia (VAP). Salah satu strategi pencegahan yang direkomendasikan adalah oral care. Namun, efektivitas berbagai bahan yang digunakan dalam oral care terhadap pencegahan VAP masih belum disepakati secara luas.
Tujuan: Untuk mengkaji efektivitas bahan oral care dalam upaya pencegahan ventilator-associated pneumonia (VAP) pada pasien kritis.
Metode: Penelitian systematic review yang mengikuti pedoman PRISMA. Artikel diperoleh dari database PubMed, ScienceDirect, dan Google Scholar dengan tahun terbit 2014–2025. Artikel yang disertakan adalah penelitian RCT atau quasi eksperimen yang membahas intervensi oral care pada pasien ventilator. Penilaian kualitas menggunakan CASP-JBI.
Hasil: Berdasarkan 10 artikel yang dikaji, bahan oral care yang digunakan meliputi chlorhexidine, hydrogen peroxide, orthodentol, lactoperoxidase, dan probiotik. Teknik oral care yang digunakan antara lain brushing dan rinsing dengan frekuensi dua hingga tiga kali per hari. Sebagian besar studi menunjukkan penurunan kejadian VAP pada kelompok intervensi.
Simpulan: Oral care efektif mencegah VAP, khususnya jika dilakukan secara teratur dengan teknik dan bahan yang tepat. Kombinasi brushing dan antiseptik seperti chlorhexidine terbukti paling optimal dalam menurunkan risiko VAP.
Kata Kunci: Oral Care; Pasien Kritis; Ventilator-Associated Pneumonia (VAP).
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