Saliva aspiration

Pneumonia (associated with reflux/saliva aspiration)... 

Oates and Schrager36 reported unsatisfactory results with acet-amidodeoxy derivatives, and preferred to use trimethylsilylated A/-ethoxycarbonyl derivatives. They used this method to analyze glycoproteins from body mucosa,328 human saliva,546 gastric aspirates,547 and bile.548... 

Brachial plexus paresis has been reported (358). Accidental block of the recurrent laryngeal nerve can cause hoarseness and occasionally aspiration of saliva (359). 

A gastric tube is inserted orally, or nasal intubation may be used if the patient has a hyperactive gag reflex. X-ray or fluoroscopic confirmation that the tip of the radio-opaque tube is in the lowest portion of the stomach is necessary. Ten or 15 minutes after the patient has become calm and adjusted to the presence of the tube, the patient is positioned with the trunlc upright and inclined sfightly to the left. Gastric juice is then aspirated and discarded. After checking that no further juice can be aspirated, note the time and collect and transfer to plastic bottles aU gastric juice that can be aspirated over the next 60 minutes. The patient must be asked to expectorate aH saliva during the collection period. The total volume of the collected juice is recorded and free acid determined by titration as described below. 

Most of the assays now carried out with isoluminol derivatives are solid-phase competitive assays (Fig. 2), in which the analyte to be determined competes with the labeled analyte for the available binding sites on antibodies that are immobilized on the solid phase. Thus, plastic microspheres have been used to immobilize antibodies for estriol (K12) or thyroxine (W9). Estradiol antibodies have been immobilized onto plastic tubes (K7) or beads (K16). In all of the above cases, the amount of immunoconjugated hormone label is inversely proportional to the amount of free hormone in the analytical sample. Unconjugated labels are removed by decantation or aspiration from the solid phase, and the specific, immunoconjugated labels are measured in a luminometer. This approach has been successfully applied to progesterone analyses in either serum (D6) or saliva (D5). A review of several separation-based assays with isoluminol analogs was presented a few years ago by Kohen et al. (K18). 

Throat swabs, blood withdrawals, nasal washes and saliva samples are isolated on the indicated (X) days. Blood specimens (3 mL) are taken by venipuncture from the cephalic vein. Nasal washes are collected by instilling 1.5 mL of sterile phosphate-buffered saline (PBS) into the nostril and immediately aspirating wash fluid and secretions with a sterile S5uinge. Saliva specimens are collected by aspiration from the cheek pouch. Prior to throat swabbing, clinical scoring of tonsillitis and pharyngeal erythema severity is performed by a trained veterinarian who is blinded to the two animal groups. 

Saliva samples from infected macaques enable testing of IgA production during the course of infection. Approximately 1 inL of saliva is collected by aspiration from the cheek pouch while the animals are under anesthesia. Saliva samples from each animal are placed into individual blue-capped 2-mL tubes and put on ice until all animal manipulations are completed. No processing of the saliva samples is required, with the tubes simply being stored at -80 °C until needed. 

Malignant fistulas between the esophagus and the respiratory system are a serious complication of esophageal cancer and occur in 5%-15% of patients (Martini et al. 1970 Little et al. 1984 Duranceau and Jamieson 1984). They may arise spontaneously as a result of tumor invasion or they may be caused by radiation therapy, surgery, pressure necrosis caused by a previously placed plastic or metallic stent, or laser therapy (Burt et al. 1991 Duranceau and Jamieson 1984 Saxon et al. 1994 Cwikiel et al. 1998). The onset of symptoms of aspiration is a devastating development for patients aheady debilitated by malnutrition caused by the dysphagia. Patients are often unable to swallow their own saliva without aspirating. 

Few, if any, patients with NMD should be left to develop unexpected ventilatory failure as appropriate assessment, self-management education, and follow-up will identify disease progression and risk of respiratory complications. When ventilatory failure occurs, tracheostomy tubes can be avoided, for the most part, irrespective of the degree of ventilator dependence, with the exception of those with insufficient bulbar-innervated musculature for speech, deglutition, and airway protection. Those with indwelling tracheostomy tubes should be offered decannulation as part of their rehabilitation, irrespective of the extent of their respiratory muscle failure. The only exceptions to this therapy are patients with advanced bulbar ALS or those with rare facioscapulohumeral muscular dystrophy, who lose all bulbar-innervated muscle function and aspirate saliva to the extent of Sao2 remaining below 95% (13). 

Saliva may be collected also in comatose cases, from d. gland, parotis under stimulation. In Sweden we usually do not get samples from stomach contents because of the reluctance of using aspiration in comatose cases. 

Finlay, E.M.H., Wilson, D.W., Adlercreutz, H., and Griffiths, K., The identification and measurement of phyto-estrogens in human saliva, plasma, breast aspirate or cyst fluid, and prostatic fluid using gas chromatography-mass spectrometry, J. Endocrinol, 129 (Suppl) 49, 1991. 

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