Descontaminação oral com terapia fotodinâmica em pacientes sob ventilação mecânica: estudo piloto

Abstract

In Intensive Care Units (ICUs), respiratory infections can range from 20 to 40% and mortality can reach 80% of those infected. Ventilator-Associated Pneumonia (VAP) is one of the main hospital acquired infection common to patients in the ICU with generally poor oral hygiene, providing the formation of oral biofilm with a prevalence of pathogenic microorganisms, especially respiratory ones. Photodynamic Therapy (PDT) is used as topical antimicrobial, which consists in using a photosensitizer that binds to the target cell and is activated by visible light, generally a low intensity laser or light emitting diode (LED). Therefore, the present study aims to evaluate the antimicrobial effect of PDT, using Curcumin solution of 10% as photosensitizer and a blue LED, observing the prevalence of microorganisms involved in VAP by means of a pilot study. It was established the participation of patients hospitalized in ICUs of a hospital in Aracaju-SE, with the a minimum period of 48 hours in mechanical ventilation, selected by spontaneous demand from October to December of 2016 and meeting the defined criteria, to this end, two patients were selected and treated with a 0.12% Chlorhexidine solution, following the disinfection protocol adopted by the institution. One patient was further treated with PDT, and the second patient served as control, without PDT. Exfoliative collections were made on the posterior region of the lingual dorsum, and on the external surface of the endotracheal tube. Regarding the collection periods for the samples, it was determined nine collection times for the PDT group and six for the CONTROL group. It should be emphasized that the evaluation criteria were similar for both groups. In this preliminary study it was verified the decontamination capacity of the oral cavity with the use of PDT, as well as its antimicrobial action against bacteria involved in VAP.