title: Inspissated oral secretions and a review of their clinical, biological, and physiological significance.
abstract: People with some chronic diseases may dehydrate and develop thick, viscous inspissated oronasal secretions that include cellular debris. This material can lead to ductal or airway obstructions that can prove to be life threatening. Asthma, allergy with superinfection, cystic fibrosis, intubated ventilation, burn injuries, and medication-induced complications are discussed in this paper. Many patients with chronic debilitating conditions may also be unable to communicate, and so may be unable to verbally convey that they have a compromised airway or an obstruction. Therefore, it is essential to maintain hydration and good oral hygiene that not only addresses the teeth and prostheses, but also the oral mucosal surfaces. People who are institutionalized and bed-ridden, in particular, need to be closely monitored to prevent adverse sequellae. A daily oral sweep with a 4 × 4 surgical sponge moistened with chlorhexidine may prevent aspiration pneumonia or a fatality due to an airway obstruction. Human oronasal secretions are involved with immunity, digestion, lubrication, and speech. Saliva is the most volumetrically important. These secretions moisturize inspired and expired air but can lose water, causing an increase in viscosity. The viscous secretions trap particles, food debris, and bacterial colonies, thereby increasing inspissations that may obstruct the airway.
authors.affiliation: Windham Community Memorial Hospital, Willimantic, Connecticut, USA. dffdds@comcast.net
authors.forename: Dennis
authors.initials: D
authors.lastname: Flanagan
mesh_terms: D000402:Airway Obstruction / Q000209:etiology; D002908:Chronic Disease; D003681:Dehydration / Q000150:complications*; D006801:Humans; D009910:Oral Hygiene; D011015:Pneumonia, Aspiration / Q000209:etiology; D012463:Saliva / Q000737:chemistry / Q000276:immunology / Q000502:physiology*; D012471:Salivary Proteins and Peptides / Q000276:immunology / Q000502:physiology; D014783:Viscosity
chemical_list: D012471:Salivary Proteins and Peptides