Hipossalivação em pacientes internados em unidade de terapia intensiva e fatores associados a esta condição

Abstract

Patients hospitalized in an intensive care unit (ICU) have a critical state of health, with immunological alterations, submitted to invasive procedures and therapeutic dehydration that contribute to the development of hyposalivation. Complementary tests such as sialometry are difficult to apply in these patients, and alternative clinical methods are important. This study sought to identify the development of hyposalivation in ICU patients and the factors associated with this condition. This was a longitudinal, cohort study, in which 48 patients admitted to the ICU of the João Machado hospital, aged over 18 years, with a minimum hospitalization time of 48 hours and who did not present hyposalivation on admission, were clinically analyzed throughout the period of stay in the ICU, to identify hyposalivation and other oral alterations. Data regarding the patients' general health were also collected. Chi-square and Fisher's exact tests were performed with a significance of 95% in addition to the relative risk analysis to analyze the possible factors associated with the presence of hyposalivation in these patients. Of the 48 research participants, 27.1% developed hyposalivation during hospitalization. Patients with this alteration were mostly male with a mean age of 59.8 years The most common findings for the diagnosis of hyposalivation were: dry mucosa, dry tongue, spatula or glove impregnation of oral structures and little/no saliva present on floor. The mean length of stay for these patients was 11.5 days. Patients with hyposalivation presented the following oral alterations: oral candidiasis, traumatic injury, dry lips, intraoral crust, extraoral crust and coated tongue. There was a significant association between the presence of dry lips and hyposalivation (p<0.05). Regarding the clinical outcome, 46.2% were discharged, 38.5% died and 15.4% was not informed. The prevalence of hyposalivation of 27.1% was considered quite significant in this population, and is associated with the presence of dry lips in these patients.