Pepsin as a marker for pulmonary aspiration.
| Autor: | Metheny NA; School of Nursing, St Louis University, Mo, USA., Chang YH, Ye JS, Edwards SJ, Defer J, Dahms TE, Stewart BJ, Stone KS, Clouse RE |
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| Jazyk: | angličtina |
| Zdroj: | American journal of critical care : an official publication, American Association of Critical-Care Nurses [Am J Crit Care] 2002 Mar; Vol. 11 (2), pp. 150-4. |
| Abstrakt: | Background: Although assessment for aspiration of small volumes of gastric contents in tube-fed patients receiving mechanical ventilation is important, available methods for this purpose are not wholly satisfactory. A potential method is immunoassay of tracheal secretions for the gastric enzyme pepsin. Objectives: To determine the frequency with which pepsin in suctioned tracheal secretions from acutely ill, tube-fed patients receiving mechanical ventilation could be detected via an immunoassay. Methods: A convenience sample of 136 specimens of suctioned tracheal secretions was collected from 30 acutely ill, tube-fed adults receiving mechanical ventilation. Multiple samples were obtained from 26 of the 30 patients (range, 2-11 per subject). An immunoassay with rooster polyclonal antibodies to purified human pepsin was used to detect pepsin in the secretions. Results: Fourteen specimens tested positive for pepsin. Secretions from 5 patients accounted for the 14 pepsin-positive results. A significant relationship was found between the position of the head of the bed and the presence of pepsin in tracheal secretions (P<.001). Of the 14 pepsin-positive specimens, 13 (92.9%) were obtained from subjects in a flat position. Conclusions: A pepsin immunoassay can be used to detect pepsin in human tracheal secretions. If pepsin in tracheal secretions is considered an indicator of aspiration of gastric contents, aspiration occurred in 5 of the 30 subjects. A flat position is strongly associated with the presence of pepsin in tracheal secretions. |
| Databáze: | MEDLINE |
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