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Treatment of drooling with scopolamine in pediatric ICU: A case series report.

Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry 2018 Vol.38(6) p. 362-366

Franco JB, Cacita N, Freua KA, Ortega KL, de Melo Peres MPS

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Drooling is a condition that affects patients with difficulties in swallowing, being common in patients with mental, neurological or dysphagic deficiency.

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APA Franco JB, Cacita N, et al. (2018). Treatment of drooling with scopolamine in pediatric ICU: A case series report.. Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 38(6), 362-366. https://doi.org/10.1111/scd.12326
MLA Franco JB, et al.. "Treatment of drooling with scopolamine in pediatric ICU: A case series report.." Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, vol. 38, no. 6, 2018, pp. 362-366.
PMID 30238487
DOI 10.1111/scd.12326

Abstract

Drooling is a condition that affects patients with difficulties in swallowing, being common in patients with mental, neurological or dysphagic deficiency. This condition is difficult to diagnose, as it is often confused with sialorrhea, and in many cases we have a hyposalivation scenario. Its diagnosis is subjective, which is why scales should be used for the standardization of the evaluation of the degree of drooling before and after the proposed treatment, as the Thomas-Stonell and Greenberg scale. It causes problems such as perioral infections, rashes, wet clothing, leading to social embarrassment, and may be a risk factor for respiratory infections caused by asymptomatic aspiration of saliva. It presents several treatments, among them the pharmacological one, that is dependent of the clinical picture of each patient that must be evaluated daily. This article refers to a series of reports of cases of children in mechanical ventilation by tracheostomy, hospitalized, with clinical diagnosis of drooling, and clinical improvement with the use of scopolamine by gastrostomy, without intercurrences during its use. The objective of this study is to show other professionals the importance of drooling management, and to expose the adopted behavior in the described cases, providing reduction of respiratory infections and improvement of the clinical and social complications resulting from drooling.

MeSH Terms

Adolescent; Child; Female; Gastrostomy; Humans; Male; Muscarinic Antagonists; Respiration, Artificial; Scopolamine; Sialorrhea; Treatment Outcome