Cuidados de higiene oral em pacientes pediátricos na unidade de terapia intensiva: revisão integrativa da literatura

Abstract

INTRODUCTION: Oral hygiene in pediatric and neonatal patients admitted to the ICU is essential to prevent ventilator-associated pneumonia (VAP). The literature points to great variation in protocols and uncertainty about which agent is most effective, especially in infants and newborns, who have a higher risk of microbial colonization. OBJECTIVES: To analyze the scientific evidence on oral hygiene strategies in pediatric and neonatal patients admitted to the ICU, comparing agents used, and their effects on VAP prevention. METHODOLOGY: An integrative review was conducted in the PubMed, Scielo, Web of Science, and BVS/Lilacs databases, using descriptors related to oral hygiene, mechanical ventilation, and pediatric patients, including articles from 2020 to 2025. After applying the selection criteria, ten studies were selected with a final sample. The data were analyzed descriptively and comparatively. RESULTS: Breast milk and colostrum were the most effective agents in reducing bacterial colonization and the incidence of VAP, as well as decreasing the duration of mechanical ventilation. Chlorhexidine showed inconsistent results, especially in younger children. Simple solutions, such as saline solution and distilled water, demonstrated low microbiological efficacy, despite being widely used. DISCUSSION: Studies show the superiority of breast milk and colostrum as safe, natural, and effective strategies. Chlorhexidine has limitations and can be irritating or ineffective in neonates. The absence of standardized protocols and dental follow-up reduces the effectiveness of oral hygiene in pediatric ICUs. FINAL CONSIDERATIONS: It is concluded that breast milk and colostrum are the most efficient options for oral hygiene in pediatric ICUs. Chlorhexidine should be used with caution, and simple solutions are not very effective. Standardization of practices and new clinical studies are essential to improve oral hygiene care in these patients.