Abstract: Objective: To explore an effective, safe and appropriate oral care frequency in improving oral health among mechanically ventilated patients with orotracheal intubation using Traditional Chinese Medicine (TCM) oral care solution, and to provide clinical practice basis for oral care using TCM oral solutino among critical patients. Methods: A total of 171 mechanically ventilated patients admitted to ICU from October 2014 to April 2017 were enrolled for the current study. Patients were randomly divided into four groups (Group A, B, C and D) in which A through C were the intervention groups. In the intervention groups, TCM oral solution was used for oral care with different frequencies: 1 time/day (Group A), 2 times/day (Group B) and 3 times/day (Group C). Group D was the control group, in which patients received routine oral care twice a day with normal saline. The length of intervention was 7 days, and the patient's oral health was evaluated using the modified Beck oral evaluation tool and pharyngeal swab test at baseline and after the intervention was completed. Results: The mean Beck oral scores at the 7th day in each intervention group all decreased significantly compared with the scores at baseline (P<0.05). Multiple between group comparisons showed that there were statistically significant differences between each of the three intervention groups (Group A, Group B, and Group C) and the control group (P<0.05) on the Beck oral score, however, no significant differences exist among the three intervention groups that used TCM oral care solution (P>0.05). The semi-quantitative detection of oral microorganism through pharyngeal swab tests showed statistically significant differences on number of oral microorganisms on day 3, 4 and 7 among four groups (P<0.05). The between group comparisons showed that the three intervention groups that used TCM oral care solution were superior to the control group in reducing the number of oral microorganisms (P<0.0083), but no statistical differences were detected among the three intervention groups (P>0.0083). Conclusion: Using TCM solution in oral care can effectively improve oral health of mechanically ventilated patients with orotracheal intubation and reduce the number of oral microorganisms. The results of this study showed that more frequent oral care using TCM oral solution among these patients did not necessarily produce better effect in improving oral health. In terms of reducing the number of oral microorganism, there are no differences whether the oral care performed once a day, twice a day or three times a day. This suggests that oral health can be achieved by reasonablea frequency oral care using TCM oral solution among mechanically ventilated patients.

Key words: Traditional Chinese Medicine; oral care; frequency; orotracheal intubation; oral function