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J Pediatr Intensive Care 2020; 09(03): 196-200
DOI: 10.1055/s-0040-1708552
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Sublingual Atropine Sulfate Use for Sialorrhea in Pediatric Patients

Ebru Azapağası 
1   Department of Pediatric Intensive Care, Ankara University Medical Faculty, Ankara, Turkey
,
Tanıl Kendirli
1   Department of Pediatric Intensive Care, Ankara University Medical Faculty, Ankara, Turkey
,
Oktay Perk
1   Department of Pediatric Intensive Care, Ankara University Medical Faculty, Ankara, Turkey
,
Gültekin Kutluk 
2   Department of Pediatric Neurology, Ankara University Medical Faculty, Ankara, Turkey
,
Gökçen Öz Tunçer
2   Department of Pediatric Neurology, Ankara University Medical Faculty, Ankara, Turkey
,
Serap Teber
2   Department of Pediatric Neurology, Ankara University Medical Faculty, Ankara, Turkey
,
Nazan Çobanoğlu
3   Department of Pediatric Pulmonology, Ankara University Medical Faculty, Ankara, Turkey
› Author Affiliations Funding None.
Further Information

Publication History

09 December 2019

16 February 2020

Publication Date:
07 April 2020 (online)

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Abstract

Sialorrhea is a frequent problem and may lead to aspiration in patients with swallowing dysfunction. We aimed to assess the effectiveness and safety of sublingual atropine sulfate treatment in pediatric patients with sialorrhea. The medical records of patients who had received sublingual atropine sulfate between January 2015 and January 2016 were reviewed retrospectively. The demographic properties, diagnosis, invasive or noninvasive mechanical ventilation need, and the presence of tracheotomy were assessed. Response rates to sublingual atropine were measured using the Teacher Drooling Scale (TDS). Pre and post-treatment drooling scores were compared. Atropine sulfate ampoule was administered at 20 µg/kg/dose. Minimum dose was 0.25 mg, while maximum dose was 0.03 mg/kg.Thirty-five pediatric patients with sialorrhea who had received sublingual atropine sulfate were identified; however, TDS scores had been recorded in only 20 of them. The median age of the patients was 25 months (3–78 months; 7 girls, 13 boys). Sixteen (80%) patients were on invasive mechanical ventilation and seven (30%) had tracheotomy. Nineteen patients had a neurodevelopmental disorder and only one patient had oral and esophageal lesions due to corrosive material intake. The median TDS score prior to sublingual atropine sulfate treatment was 5, and it decreased to 3 on the second day of treatment, a change that was statistically significant (p < 0.001). No side effects were observed. Sublingual atropine sulfate is safe and effective in the short-term treatment of sialorrhea; however, randomized placebo controlled and long-term follow-up studies are necessary.

Keywords

atropine sulfate - sublingual - sialorrhea - pediatric patients

Ethical Approval

The hospital's Ethics Review Board, considering a retrospective study, waived the need for patient consent for the study.


 

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