Periodontitis in the development of ventilator-associated Pneumonia

Enzyme-laden saliva associated with periodontal disease can modify mucosal surfaces to promote adhesion and colonization by respiratory pathogens. Objective: The objective of this study was to evaluate the occurrence of oxidative stress resulting from periodontal inflammation in the development of VAP in patients admitted to the Intensive Care Unit (ICU). Method: Clinical, cross-sectional and observational study. Subjects were assessed for the presence or absence of periodontitis and VAP. 117 patients were evaluated, however, 53 patients were included in the study. Divided into 3 groups: Control (n=17), periodontitis and without VAP (n=30), Periodontitis and with VAP (n=6). Clinical periodontal examination, collection and quantification of gingival crevicular fluid, collection of saliva and tracheal secretion for analysis of the antioxidant system and oxidative stress, hematological tests and other patient data were performed. Results: in the clinical periodontal examination, patients with periodontitis, but without VAP, presented significantly higher values. Hematological tests, urea and creatinine showed significant differences. The variables related to the antioxidant system and oxidative stress, in saliva, were different in the group of control patients and in the group with periodontitis, the SOD enzyme was inhibited and LPO was increased. And in the saliva of the groups of patients with periodontitis, there was an increase in SOD, CAT and GR in the Periodontitis + VAP group. In the integrative analysis of saliva, Dimension 3 (GST), there was a difference in the group with Periodontitis+VAP. In the analysis of tracheal secretion in patients with Periodontitis, GR and GST showed significant induction and inhibition. Conclusion: The increase in oxidative stress caused by the inflammation of periodontitis can alter the antioxidant status, facilitating the development of VAP.