Sialorrhea in the assessment and correction of water balance in a 2 month old baby in the ICU: a case report

Abstract

INTRODUCTION: In some cases, saliva production (sialorrhea — hypersalivation) can be so significant that it needs to be monitored and accounted for in the assessment and maintenance of the patient's water balance. OBJECTIVE: Description of a clinical case of sialorrhea, which had a clinically significant manifestation in the assessment and maintenance of water balance in a 2-month-old child in the intensive care unit (ICU). MATERIALS AND METHODS: Baby, 2 month old, was treated in the ICU with a diagnosis: perinatal organic hypoxic-ischemic lesion of the central nervous system of a newborn, congenital pathology of the brain, respiratory failure III stage, convulsions of the newborn, neonatal coma. In the complex of specific therapy, he received enteral feeding, correction of water and nutritional status. RESULTS: On the first day of detection of sialorrhea, the level of salivation of 2.81 ml/kg/hour (the norm is 1.3 ml/kg/hour) exceeded the physiological values by more than 2 times. The excess of normal values of salivation persisted for the next two days, as well as on the 9th day of its control, which required taking into account the amount of fluid lost with saliva in the calculation of its daily requirement. No specific measures were required in the treatment of the patient to eliminate sialorrhea; within 14 days from the moment the fact of sialorrhea was established, the level of salivation returned to normal values. CONCLUSIONS: In assessing the cumulative factors that cause fluid loss in ICU patients, especially infants, it is also necessary to take into account the presence and intensity of salivation, which can manifest as sialorrhea, when calculating the volume and administration of infusion drugs.