• Nicholas M Mohr, Carlos A Pelaez Gil, Karisa K Harland, Brett Faine, Andrew Stoltze, Kent Pearson, and Azeemuddin Ahmed.
• Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA; Division of Critical Care, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA. Electronic address: nicholas-mohr@uiowa.edu.
• J Crit Care. 2015 Aug 1;30(4):787-92.

PurposeThe purpose of the study was to test the hypothesis that prehospital oral chlorhexidine administered to intubated trauma patients will decrease the Clinical Pulmonary Infection Score (CPIS) during the first 2 days of hospitalization.Materials And MethodsProspective interventional concurrent-control study of all intubated adult trauma patients transported by air ambulance to a 711-bed Midwestern academic trauma center over a 1-year period. Patients transported by 2 university-based helicopters were treated with oral chlorhexidine after intubation, and the control group was patients transported by other air transport services.ResultsSixty-seven patients were enrolled, of which 23 received chlorhexidine (9 patients allocated to the intervention were not treated). The change in CPIS score was no different between the intervention and control groups by intention to treat (1.06- vs 1.40-point reduction, P = .520), and no difference was observed in tracheal colonization (29.0% vs 36.7%, P = .586). No differences were observed in the rate of clinical pneumonia (8.7% vs 8.6%, P = .987) or mortality (P = .196) in the per-protocol chlorhexidine group.ConclusionsThe prehospital administration of oral chlorhexidine does not reduce the CPIS score over the first 48 hours of admission for intubated trauma patients. Further study should explore other prehospital strategies of reducing complications of critical illness.Copyright © 2015 Elsevier Inc. All rights reserved.

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