AJCC
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

American Journal of Critical Care. 2002;11: 150-154
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Respond to This Article
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Metheny, N. A.
Right arrow Articles by Clouse, R. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Metheny, N. A.
Right arrow Articles by Clouse, R. E.

Pepsin as a Marker for Pulmonary Aspiration

By Norma A. Metheny, RN, PhD, Yie-Hwa Chang, PhD, Jing Song Ye, PhD, Sharon J. Edwards, RN, MSN, Julie Defer, RN, BSN, Thomas E. Dahms, PhD, Barbara J. Stewart, PhD, Kathleen S. Stone, RN, PhD and Ray E. Clouse, MD. From School of Nursing (NAM, JSY, SJE, JD), School of Medicine (Y-HC, TED), St. Louis University, St Louis, Mo, Oregon Health Sciences University, Portland, Ore (BJS), Ohio State University School of Nursing, Cleveland, Ohio (KSS), and Washington University School of Medicine, St Louis, Mo (REC).

• 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.




This article has been cited by other articles:


Home page
 ChestHome page
V. Starosta, R. Kitz, D. Hartl, V. Marcos, D. Reinhardt, and M. Griese
Bronchoalveolar Pepsin, Bile Acids, Oxidation, and Inflammation in Children With Gastroesophageal Reflux Disease
Chest, November 1, 2007; 132(5): 1557 - 1564.
[Abstract] [Full Text] [PDF]

Home page
 Home Health Care Management PracticeHome page
J. A. DePalma
Using Evidence in Home Care: The Value of a Librarian-Clinician Collaboration--the Clinician's Role
Home Health Care Management Practice, June 1, 2005; 17(4): 302 - 307.
[Abstract] [PDF]

Home page
 Nutr Clin PractHome page
C. M. Parker and D. K. Heyland
Aspiration and the Risk of Ventilator-Associated Pneumonia
Nutr Clin Pract, December 1, 2004; 19(6): 597 - 609.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. L. Meert, K. M. Daphtary, and N. A. Metheny
Gastric vs Small-Bowel Feeding in Critically Ill Children Receiving Mechanical Ventilation: A Randomized Controlled Trial
Chest, September 1, 2004; 126(3): 872 - 878.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2002 by the American Association of Critical-Care Nurses.