medigraphic.com
ISSN 1608-8921 (Impreso)

2023, Número 1

<< Anterior

Gaceta Médica Espirituana 2023; 25 (1)


Salud bucal en pacientes en estado crítico

Expósito LA, Feria DGE, Valdés CRC

Idioma: Español
Referencias bibliográficas: 32
Paginas: 1-14
Archivo PDF: 374.69 Kb.


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.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. 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

  2. Takahama A Jr, de Sousa VI, Tanaka EE, Ono E, Ito FAN, Costa PP, et al. Analysis of oral risk factors for ventilatorassociatedpneumonia 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

  3. Martínez M, Postolache TT, García-Bueno B, Leza JC, Figuero E, Lowry CA, et al. The Role of the Oral MicrobiotaRelated 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

  4. Nomura Y, Ishii Y, Suzuki S, Morita K, Suzuki A, Suzuki S, et al. Nutritional Status and Oral Frailty: A CommunityBased 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

  5. Sánchez-Peña MK, Orozco-Restrepo LA, Suárez-Brochero ÓF, Barrios-Arroyave FA. Association between oralhealth, pneumonia and mortality in patients of intensive care. Rev Med Inst Mex Seguro Soc [Internet] 2020 [cited2022 Dec 25];58(4):468-476. Available from:http://revistamedica.imss.gob.mx/editorial/index.php/revista_medica/article/view/3625/4105

  6. Muramatsu K, Matsuo K, Kawai Y, Yamamoto T, Hara Y, Shimomura Y, et al. Comparison of wiping and rinsingtechniques after oral care procedures in critically ill patients during endotracheal intubation and after extubation: Aprospective 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

  7. Sato S, Takahashi H. Assessment of the risk of malnutrition due to aspiration pneumonia and oral feeding difficulty.Nutr Hosp [Internet]. 2020 [cited 2022 Dec 30];37(4):723-729. Available from:https://pubmed.ncbi.nlm.nih.gov/32720506/ https://doi.org/10.20960/nh.03109

  8. Vieira PC, de Oliveira RB, da Silva Mendonça TM. Should oral chlorhexidine remain in ventilator-associatedpneumonia 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%3Dihubhttps://doi.org/10.1016/j.medine.2020.09.010

  9. Haghighi A, Shafipour V, Bagheri-Nesami M, Gholipour Baradari A, Yazdani Charati J. The impact of oral care onoral 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%3Dihubhttps://doi.org/10.1016/j.aucc.2016.07.002

  10. 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 analysisof 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.pdfhttps://doi.org/10.1186/s13054-019-2664-6

  11. 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 [cited2022 Dec 30];26(4):224-233. Available from: https://pubmed.ncbi.nlm.nih.gov/33124119/

  12. Cruz JC, Martins CK, Piassi JEV, Garcia Júnior IR, Santiago Junior JF, Faverani LP. Does chlorhexidine reducethe incidence of ventilator-associated pneumonia in ICU patients? A systematic review and meta-analysis. MedIntensiva (Engl Ed) [Internet]. 2022 [cited 2022 Dec 30];S2173-5727(22). Available from:https://www.sciencedirect.com/science/article/abs/pii/S2173572722003290?via%3Dihub

  13. Saensom D, Merchant AT, Wara-Aswapati N, Ruaisungnoen W, Pitiphat W. Oral health and ventilator-associatedpneumonia 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

  14. Munro CL, Grap MJ, Elswick RK Jr, McKinney J, Sessler CN, Hummel RS. Oral health status and development ofventilator-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

  15. Moosavi MS, Aminishakib P, Ansari M. Antiviral mouthwashes: possible benefit for COVID-19 with evidence-basedapproach. 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

  16. Choi MI, Han SY, Jeon HS, Choi ES, Won SE, Lee YJ, et al. The Effect of Professional Oral Care on the OralHealth Status of Critical Trauma Patients Using Ventilators. Int J Environ Res Public Health [Internet]. 2022 [cited 2022Dec 30];19(10). Available from: https://www.mdpi.com/1660-4601/19/10/6197

  17. Liao YM, Tsai JR, Chou FH. The effectiveness of an oral health care program for preventing ventilator-associatedpneumonia. Nurs Crit Care [Internet]. 2015 [cited 2022 Dec 25];20(2):89-97. Available from:https://onlinelibrary.wiley.com/doi/10.1111/nicc.12037

  18. Sánchez-Sánchez R, Sigcho-Romero C, Teruel-Ginés R, Tamayo-Ortíz B. Una asociación peligrosa: COVID-19y enfermedad periodontal. CCM [Internet]. 2022 [citado 30 Dic 2022];26(2). Disponible en:https://revcocmed.sld.cu/index.php/cocmed/article/view/4401

  19. Sánchez Sánchez RJ, Sigcho Romero CR, Niño Peña A. Una díada de riesgo: periodontitis y COVID-19. GacMéd 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

  20. Cantón-Bulnes ML, Garnacho-Montero J. Antisepsia orofaríngea en el paciente crítico y en el paciente sometidoa ventilación mecánica. Medicina Intensiva [Internet]. 2019 [citado 25 Dic 2022];43(Supl1):23-30. Disponible en:https://medintensiva.org/es-pdf-S0210569118302559

  21. Antalová N, Klučka J, Říhová M, Poláčková S, Pokorná A, Štourač P. Ventilator-Associated Pneumonia Preventionin Pediatric Patients: Narrative Review. Children (Basel) [Internet]. 2022 Oct 9 [citado 30 Dic 2022];9(10). Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9600673/pdf/children-09-01540.pdf

  22. Melchior LMR, Santos ER, Carvalho BDP, Margarida MCA, Pereira TLCS, Paulo GML, et al. Treinamento dehigiene oral em paciente crítico. R Rev. enferm. UFPE on line [Internet]. 2021 [cited 2022 Dec 25];15(1):1-9. Availablefrom: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/245930/37550#

  23. Jackson L, Owens M. Does oral care with chlorhexidine reduce ventilator-associated pneumonia in mechanicallyventilated 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

  24. 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 delEquipo 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

  25. Álvarez Lerma F, Sánchez García M, Lorente L, Gordo F, Añón JM, Álvarez J. Guidelines for the prevention ofventilator-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-preventionventilator-associated-pneumonia-articulo-S217357271400023X

  26. Rivera-Ramos ES. La importancia del OHIP (Oral Health Impact Profile) en la Odontología. Odontol Sanmarquina[Internet]. 21 de febrero de 2020 [citado 16 de Dic de 2022];23(1):35-42. Disponible en:https://revistasinvestigacion.unmsm.edu.pe/index.php/odont/article/view/17505/14703

  27. de Camargo L, da Silva SN, Chambrone L. Efficacy of toothbrushing procedures performed in intensive care unitsin reducing the risk of ventilator-associated pneumonia: A systematic review. J Periodontal Res [Internet]. 2019 [cited2022 Dec 25];54(6):601-611. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jre.12668

  28. Zhao T, Wu X, Zhang Q, Li C, Worthington HV, Hua F. Oral hygiene care for critically ill patients to preventventilator-associated pneumonia. Cochrane Database Syst Rev [Internet]. 2020 [cited 2022 Dec 25];12(12). Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460950/pdf/CD008367.pdf

  29. Lee S, Lighvan NL, McCredie V, Pechlivanoglou P, Krahn M, Quiñonez C, et al. Chlorhexidine-Related MortalityRate 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

  30. Hua F, Xie H, Worthington HV, Furness S, Zhang Q, Li C. Oral hygiene care for critically ill patients to preventventilator-associated pneumonia. Cochrane Database Syst Rev [Internet]. 2016 [cited 2022 Dec 25];10(10). Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460950/pdf/CD008367.pdf

  31. Moreno Sancho F, Tsakos G, Brealey D, Boniface D, Needleman I. Development of a tool to assess oral healthrelatedquality of life in patients hospitalised in critical care. Qual Life Res [Internet]. 2020 [cited 2022 Dec30];29(2):559-568. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994456/pdf/11136_2019_Article_2335.pdf

  32. Marouf N, Cai W, Said KN, Daas H, Diab H, Chinta VR, et al. Association between periodontitis and severity ofCOVID-19 infection: A case-control study. J Clin Periodontol. 2021 Apr [cited 2022 Dec 30];48(4):483-491. Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014679/pdf/JCPE-48-483.pdf




2020     |     www.medigraphic.com