Contribution of impairment of cough and swallowing reflexes and silent aspiration of oropharyngeal bacteria to the mechanism of postoperative pneumonia

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This study reconfirmed the close relevance of impairment of cough and swallowing reflexes to postoperative pneumonia after lung resection. We showed the bronchial fluid from patients developing postoperative pneumonia contained considerable oral anaerobic bacteria, by using oral biochemical technique. Our intensive perioperative oral care program, including professional assessment of oral status, dental cleaning, and patient education for self-oral care by a dentist, followed by intensive oral care at least 3 times a day by ICU nurses, and encouragement of self-oral care by floor nurses, tended to decrease anaerobic bacterial amounts in the bronchial fluid and prevented the incidence of postoperative pneumonia.