الفهرس 
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Abstract
8Ventilator Associated Pneumonia (VAP) remain a leading cause from hospital acquired infections, especially in intensive care units and associated with significant patient morbidity, mortality and hospital costs. There are potential sources for ventilator associated pneumonia: invasive medical devices such as nasogastric tubes and endotracheal tubes cause aspiration colonize the upper respiratory tract and hematogenously acquired infections originate from a distant source and reach the lungs via the bloodstream. The aim of the current study is to determine the effect of combination of Sodium monofluorophosphate 0.7% with chlorhexidine0. 12% in oral care on Ventilator associated Pneumonia among critically ill patients. Research Setting: The current study was conduted at Intinsive Care Unites (Surgical, Cardic, Chest and Neurological unite) of Menofyia University Hospital . Research Design : To achieve the aim of this study, the reseacher was utailized experimental reseach design. Subjects: Subjects of this study were compromised of a random sample of 60 adults patients divided randomly and alternatively into two equal groups; 30 patients each. >١٠٦< Study group (I) oral hygiene will be done using Sodium monofluorophosphate0.7% with chlorhexidine 0.12%. Control group (II) will be exposed to routine hospital care. Inclusions criteria included the following: 1 Immediately after intubations within 24 hours of admission to ICU. 2 Unconscious patient of both sexes. 3 Adult (21 to 60) years old. 4 Normal vital signs. 5 Previous history of pneumonia 6 Free from any risk factors for infection as diabetes or immunocompromised diseases. Variables: The independent variable was using of sodium monofluorophosphat 0.7% and chlorhexidine 0.12% for oral hygiene. While the dependent variable was ventilator associated pneumonia among critically ill patients. Tools: Two tools were developed and utilized by the researcher for data collection . These tools are: Tool 1 : Biophysiological Measurements : Ventilator associated Pneumonia : (Appendix II). Tool 2 : Observational Check List : Ventilator associated Pneumonia : (Appendix III). The main finding of the present study were: 1. There were significantly higher of normal swallowing reflex , smooth lips, pink lips, moist lips in patient used oral care by antiseptic solution . >١٠٧
2. There were significantly higher clean teeth with no debris and dental plaque in patient used oral care by antiseptic solution . 3. There were significantly lower of vital signs in the patient had oral care with sodium monofluorophosphat 0.7% and chlorhexidine 0.12%. 4. Most common signs and symptoms of ventilator associated pneumonia were Cough that may produce mucus like, greenish, or brown like sputum, Chills, Shortness of breath and vomiting 5. There was The mean value of WBC s, HbB, HCt, PH, Pao2 & HCo3 were significantly lower on admission than post oral care in study group. 6. Oral care with sodium monofluorophosphat 0.7% significantly.