A new pepsin assay to detect pulmonary aspiration of gastric contents among newly, intubated patients
A new pepsin assay to detect pulmonary aspiration of gastric contents among newly, intubated patients
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DOI：
10.1016/j.ajem.2004.08.019
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发表时间：
2004-11-01
影响因子：
3.6
通讯作者：
Kueppers, F
中科院分区：
文献类型：
--
作者：
Ufberg, JW;Bushra, JS;Kueppers, F
气管内插管患者吸入胃内容物与显著的发病率和死亡率相关。以往的研究表明，胃蛋白酶在气管吸出物可能是一个有价值的标志物隐匿性吸入。我们试图证明一种新的胃蛋白酶特异性检测方法在人体中的灵敏度和特异性。在计划的气管内和鼻胃插管进行择期手术后，20名参与者撤回了气管和胃抽吸物。设盲研究者使用该测定法检测样品中是否存在胃蛋白酶。然后用胃蛋白酶抑制剂（一种特异性胃蛋白酶抑制剂）对阳性样本进行检测，以确保阳性结果是由胃蛋白酶引起的。所有气管抽吸物检测结果均为阴性，所有胃抽吸物检测结果均为胃蛋白酶阳性。胃蛋白酶抑制剂在所有阳性样品中停止胃蛋白酶活性，确保阳性结果是由于胃蛋白酶。胃蛋白酶特异性测定对于检测人类胃内容物是非常可靠的。
Aspiration of gastric contents by endotracheally intubated patients is associated with significant morbidity and mortality. Previous studies suggest that pepsin in tracheal aspirates may be a valuable marker of occult aspiration. We sought to show the sensitivity and specificity of a new, pepsin-specific assay in humans.A prospective, case-controlled study was conducted with subjects serving as their own controls. After planned endotracheal and nasogastric intubation for elective surgery, 20 participants had tracheal and gastric aspirates withdrawn. A blinded investigator tested samples for the presence of pepsin using the assay. Positive samples were then tested with pepstatin, a specific pepsin inhibitor, to ensure that positive results were due to pepsin.All tracheal aspirates tested negative and all gastric aspirates tested positive for pepsin. Pepstatin halted pepsin activity in all positive samples, ensuring that positive results were due to pepsin. A pepsin-specific assay is extremely reliable for detecting gastric contents in humans.