PDF(Pubmed)
Abstract：
Sialorrhea is common in children with neurodevelopmental disabilities (NDD) and is reported in >40% of children with cerebral palsy (CP). It causes a range of complications, including significant respiratory morbidity. This single-center retrospective chart review aims to document sublingual atropine (SLA) utilization to guide further study in establishing its role in secretion management for children with NDD. A chart review was completed for patients with NDD ≤ 22 years of age treated with SLA at a free-standing children\'s hospital between 1 January 2016 and 1 June 2021. Descriptive statistics were generated to summarize findings. In total, 190 patients were identified, of which 178 met inclusion criteria. The average starting dose for SLA was 1.5 mg/day, or 0.09 mg/kg/day when adjusted for patient weight. Eighty-nine (50%) patients were prescribed SLA first line for secretion management while 85 (48%) patients tried glycopyrrolate prior to SLA. SLA was used after salivary Botox, ablation, and/or surgery in 16 (9%) patients. This study investigates SLA as a potential pharmacologic agent to treat sialorrhea in children with NDD. We identify a range of prescribing patterns regarding dosing, schedule, and place in therapy, highlighting the need for further evidence to support and guide its safe and efficacious use.
摘要：
泪液在神经发育障碍（NDD）儿童中很常见，据报道在>40％的脑瘫（CP）儿童中。它会导致一系列并发症，包括显著的呼吸道发病率。此单中心回顾性图表审查旨在记录舌下阿托品（SLA）的使用情况，以指导进一步研究确定其在NDD儿童分泌管理中的作用。对2016年1月1日至2021年6月1日期间在独立儿童医院接受SLA治疗的NDD≤22岁患者进行了图表审查。生成描述性统计数据来总结发现。总的来说,190名患者被确认，其中178人符合纳入标准。SLA的平均起始剂量为1.5mg/天，或0.09mg/kg/天，当调整患者体重。89例（50％）患者接受了SLA一线的分泌管理，而85例（48％）患者在SLA之前尝试了格隆溴铵。在唾液肉毒杆菌素之后使用SLA，消融,和/或手术16（9％）患者。这项研究调查了SLA作为治疗NDD儿童流涕的潜在药物。我们确定了一系列关于给药的处方模式，时间表,并放置在治疗中，强调需要进一步的证据来支持和指导其安全有效的使用。
