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Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series

Sialorrhea is a major cause of recurrent aspiration pneumonia in severe chronic brain injury. Previous reports have shown that transdermal scopolamine can decrease saliva production. We present four patients with severe chronic brain injury who experienced repeat aspiration pneumonia with sialorrhea...

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Autores principales: Yamaki, Tomohiro, Takahashi, Kyoko, Azuhata, Osamu, Itou, Daisuke, Yakufujiang, Madinum, Oka, Nobuo, Odaki, Masaru, Kobayashi, Shigeki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082737/
https://www.ncbi.nlm.nih.gov/pubmed/35548103
http://dx.doi.org/10.1177/2050313X221096227
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author Yamaki, Tomohiro
Takahashi, Kyoko
Azuhata, Osamu
Itou, Daisuke
Yakufujiang, Madinum
Oka, Nobuo
Odaki, Masaru
Kobayashi, Shigeki
author_facet Yamaki, Tomohiro
Takahashi, Kyoko
Azuhata, Osamu
Itou, Daisuke
Yakufujiang, Madinum
Oka, Nobuo
Odaki, Masaru
Kobayashi, Shigeki
author_sort Yamaki, Tomohiro
collection PubMed
description Sialorrhea is a major cause of recurrent aspiration pneumonia in severe chronic brain injury. Previous reports have shown that transdermal scopolamine can decrease saliva production. We present four patients with severe chronic brain injury who experienced repeat aspiration pneumonia with sialorrhea. Longitudinal computed tomography examinations to assess the therapeutic effect were performed in all four cases before and after transdermal scopolamine. Transdermal scopolamine was applied as a patch (0.1 g/2.5 cm(2)) behind the earlobe every 24 h after confirming the absence of glaucoma. Patches were formulated as an in-hospital preparation (scopolamine butylbromide 0.25 g and hydrophilic cream 4.75 g) under the approval of our institutional review board. Longitudinal computed tomography after transdermal scopolamine use showed a decrease in pleural effusions associated with continuous aspiration pneumonia in all four cases. The data from repeat computed tomography suggest that long-term transdermal scopolamine for reducing saliva production may be a reasonable option for appropriate palliative care in severe chronic brain injury patients.
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spelling pubmed-90827372022-05-10 Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series Yamaki, Tomohiro Takahashi, Kyoko Azuhata, Osamu Itou, Daisuke Yakufujiang, Madinum Oka, Nobuo Odaki, Masaru Kobayashi, Shigeki SAGE Open Med Case Rep Case Report Sialorrhea is a major cause of recurrent aspiration pneumonia in severe chronic brain injury. Previous reports have shown that transdermal scopolamine can decrease saliva production. We present four patients with severe chronic brain injury who experienced repeat aspiration pneumonia with sialorrhea. Longitudinal computed tomography examinations to assess the therapeutic effect were performed in all four cases before and after transdermal scopolamine. Transdermal scopolamine was applied as a patch (0.1 g/2.5 cm(2)) behind the earlobe every 24 h after confirming the absence of glaucoma. Patches were formulated as an in-hospital preparation (scopolamine butylbromide 0.25 g and hydrophilic cream 4.75 g) under the approval of our institutional review board. Longitudinal computed tomography after transdermal scopolamine use showed a decrease in pleural effusions associated with continuous aspiration pneumonia in all four cases. The data from repeat computed tomography suggest that long-term transdermal scopolamine for reducing saliva production may be a reasonable option for appropriate palliative care in severe chronic brain injury patients. SAGE Publications 2022-05-06 /pmc/articles/PMC9082737/ /pubmed/35548103 http://dx.doi.org/10.1177/2050313X221096227 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Yamaki, Tomohiro
Takahashi, Kyoko
Azuhata, Osamu
Itou, Daisuke
Yakufujiang, Madinum
Oka, Nobuo
Odaki, Masaru
Kobayashi, Shigeki
Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series
title Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series
title_full Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series
title_fullStr Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series
title_full_unstemmed Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series
title_short Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series
title_sort longitudinal ct evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082737/
https://www.ncbi.nlm.nih.gov/pubmed/35548103
http://dx.doi.org/10.1177/2050313X221096227
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