Inadequate salivary flow and poor oral mucosal status in intubated intensive care unit patients.

P.J.W. Dennesen, A. van der Ven, M. Vlasveld, L. Lokker, G. Ramsay, A. Kessels, P. van den Keijbus, A. van Nieuw Amerongen, E. Veerman

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Abstract

Inadequate salivary flow and poor oral mucosal status in intubated intensive care unit patients.

Dennesen P, van der Ven A, Vlasveld M, Lokker L, Ramsay G, Kessels A, van den Keijbus P, van Nieuw Amerongen A, Veerman E.

Department of Medical Microbiology, University Hospital of Maastricht, The Netherlands.

OBJECTIVE: To investigate salivary flow and frequency of oral mucositis in intensive care unit patients compared with patients admitted because of elective coronary artery bypass graft (CABG) surgery. In addition, the pattern of oropharyngeal colonization was investigated in these patients. DESIGN: Prospective study. SETTING: Mixed intensive care unit and cardiosurgical ward. PATIENTS: In this study, 24 ventilated intensive care unit patients and 20 CABG patients were included. MEASUREMENTS AND MAIN RESULTS: Two dental hygienists examined intensive care unit patients for the presence of periodontal disease and mucositis at admission and subsequently every week during their stay in the intensive care unit. At the same time, stimulated salivary flow and salivary total immunoglobulin A output were measured. Oropharyngeal cultures were obtained as well. CABG patients were examined the day before the operation, 1 day, 1 wk, and 2 wks after the operation. The following results were obtained: a) temporarily reduced postoperative stimulated salivary flow and total salivary immunoglobulin A output in CABG patients and nearly absent stimulated salivary flow in intensive care unit patients; b) oropharyngeal colonization with potentially pathogenic microorganisms in intensive care unit and not in CABG patients; and c) the increase in mucositis index in intensive care unit patients paralleled the increase in potentially pathogenic microorganism oropharyngeal colonization, especially and. CONCLUSIONS: Absence of adequate salivary flow in intubated intensive care unit patients causes severe xerostomia, which may contribute to the development of mucositis and oropharyngeal colonization with Gram-negative bacteria.

Original languageEnglish
Pages (from-to)781-786
Number of pages6
JournalCritical Care Medicine
Volume31
Issue number3
DOIs
Publication statusPublished - 1 Jan 2003

Cite this

Dennesen, P. J. W., van der Ven, A., Vlasveld, M., Lokker, L., Ramsay, G., Kessels, A., van den Keijbus, P., van Nieuw Amerongen, A., & Veerman, E. (2003). Inadequate salivary flow and poor oral mucosal status in intubated intensive care unit patients. Critical Care Medicine, 31(3), 781-786. https://doi.org/10.1097/01.CCM.0000053646.04085.29