重症患者の口腔管理 : ICU における専門的口腔ケアの取り組み

In-depth oral care toward severe human cases is crucial for the management of their general condition. As a matter of fact, maintenance of a good oral hygiene condition can reduce the risk for developing respiratory diseases such as aspiration pneumonia and ventilator-associated pneumonia. In September ２００７, we initiated at Tokushima University Hospital Intensive Care Unit （ICU）a collaboration between nurses and medical doctors to provide professional oral care to patients. The aim of this activity was to establish a standardized protocol of oral care in order to reduce the risk for infectious disease complications for inpatients undergoing respiratory care. At the initial oral examination, the majority of patients in ICU had dry lips, and showed tongue coating and the presence of oral debris on tooth and oral mucosa surfaces. In addition, we sometimes observed ulcer formation on oral mucosa or tooth mobility, which are conditions that ICU members should pay an attention when fixing the endotracheal tube. Our professional oral care protocol reduced oral debris, dry mouth, and oral malodor to some extent in the majority of patients at ICU. An intensive collaboration between dental professionals with nurses and medical doctors, was favored through this activity. Our long-term objective is to contribute to the maintenance of general condition continuously as a member of multi-professional team.