Study of Povidone Iodine to Reduce Pulmonary Infection in Head Trauma and Cerebral Hemorrhage in Intensive Care Unit

Prospective Randomized Double Blind Study Comparing the Effect of Oropharyngeal Decontamination by Povidone-iodine to Placebo on Ventilator-associated Pneumonia in Patients With Head Trauma or Cerebral Hemorrhage

Head trauma and severe cerebral hemorrhage are major risk factors for development of ventilator-associated pneumonia. In a previous open labelled, single center study the investigators showed that repeated oropharyngeal decontamination with povidone-iodine may be an effective strategy to decrease the prevalence of ventilator-associated pneumonia in patients with head trauma. The present study aims to confirm these results in a multicenter, double blind study including patients suffering from head trauma or cerebral hemorrhage.

Inclusion Criteria:

• Adults > 18 years
• Closed head trauma with a Glasgow Coma Score <=8 or cerebral Hemorrhage with a Glasgow Coma Score of <=8
• Expected need mechanical ventilation for >=2 days
• Written informed consent from the patient's next-of-kin. If no relative is present at the time of inclusion, the patients will be included according to the emergency procedure

Exclusion Criteria:

• Impossibility to perform oropharyngeal decontamination within 12 h following the initial episode
• Facial injury with impossibility to perform the oropharyngeal decontamination
• Tetraplegia
• Known history of reaction to iodine
• Respiratory disease or pulmonary infiltrate(s) at inclusion
• Need for curative antibiotics
• Mercurial antiseptics treatment
• Pregnancy