Background
Trainee anaesthetists working in South West hospitals observed that patients having major abdominal surgery were at risk of developing post-operative pneumonia.
Inhaling secretions from the mouth and throat is one of many factors that can contribute to the development of post-operative pneumonia. Previous research has shown that reducing concentrations of oral pathogenic microorganisms with an antiseptic such as chlorhexidine may reduce ventilator associated pneumonia in critical care patients, as well as reducing pneumonia in nursing home residents. Regular oral disinfection is standard care for intubated patients in Intensive Care Units who are unable to attend to their own dental hygiene.
The trainees wondered whether rigorous attention to oral hygiene might reduce post-operative pneumonia in patients undergoing major abdominal surgery. Through the South West Anaesthesia Research Matrix (SWARM) they carried out a feasibility study (CUPPA) across six NHS hospitals in the South West, with a view to planning and implementing a randomised controlled trial (RCT) to test this hypothesis.
The ‘CUPPA’ (Comprehensive moUth-care to reduce Post-operative PneumoniA) trial was funded by a grant from the National Institute of Academic Anaesthesia (NIAA) with support from PenCLAHRC.
What is SWARM?
SWARM (South West Anaesthesia Research Matrix) is a trainee-led research collaborative with over 200 members across the South West, set up to break through the glass ceiling that can prevent trainees from being credible Principal or Chief Investigators. Individual trusts and funders are hesitant to invest in doctors on rotations because they have insufficient time to gain traction at a particular hospital before moving on.
The network model overcomes these issues, as the SWARM network, supported by consultant mentors, can grow research ideas from inception to delivery. By running projects in parallel at six hospital sites, an economy of scale achieves meaningful volume quickly.
Project Lead: Dr Charly Gibson, Royal Devon & Exeter Hospital