Accuracy of Alpha Amylase in Diagnosing Microaspiration in Intubated Critically-Ill Patients
Rattachement africain : fr. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVES: Amylase concentration in respiratory secretions was reported to be a potentially useful marker for aspiration and pneumonia. The aim of this study was to determine accuracy of α-amylase in diagnosing microaspiration in critically ill patients. METHODS: Retrospective analysis of prospectively collected data collected in a medical ICU. All patients requiring mechanical ventilation for at least 48 h, and included in a previous randomized controlled trial were eligible for this study, provided that at least one tracheal aspirate was available for α-amylase measurement. As part of the initial trial, pepsin was quantitatively measured in all tracheal aspirates during a 48-h period. All tracheal aspirates were frozen, allowing subsequent measurement of α-amylase for the purpose of the current study. Microaspiration was defined as the presence of at least one positive tracheal aspirate for pepsin (>200 ng.mL-1). Abundant microaspiration was defined as the presence of pepsin at significant level in >74% of tracheal aspirates. RESULTS: Amylase was measured in 1055 tracheal aspirates, collected from 109 patients. Using mean α-amylase level per patient, accuracy of α-amylase in diagnosing microaspiration was moderate (area under the receiver operator curve 0.72±0.05 [95%CI 0.61-0.83], for an α-amylase value of 1685 UI.L-1). However, when α-amylase levels, coming from all samples, were taken into account, area under the receiver operator curve was 0.56±0.05 [0.53-0.60]. Mean α-amylase level, and percentage of tracheal aspirates positive for α-amylase were significantly higher in patients with microaspiration, and in patients with abundant microaspiration compared with those with no microaspiration; and similar in patients with microaspiration compared with those with abundant microaspiration. α-amylase and pepsin were significantly correlated (r2 = 0.305, p = 0.001). CONCLUSION: Accuracy of mean α-amylase in diagnosing microaspiration is moderate. Further, when all α-amylase levels were taken into account, α-amylase was inaccurate in diagnosing microaspiration, compared with pepsin.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Accuracy of Alpha Amylase in Diagnosing Microaspiration in Intubated Critically-Ill Patients
- Date Crossref
- 06/03/2014
- Éditeur
- Public Library of Science (PLoS)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Université de Lille pays non établi dans la noticeUniversité ou école supérieure
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Centre Hospitalier Universitaire de Bordeaux pays non établi dans la noticeÉtablissement de santé
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Université Lille Nord de France pays non établi dans la noticeUniversité ou école supérieure
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Hôpital Roger Salengro pays non établi dans la noticeÉtablissement de santé
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Valenciennes Hospital Intensive Care Unit pays non établi dans la noticeÉtablissement de santé
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Faculty of Pharmacy Biochemistry and Molecular Biology Laboratory pays non établi dans la noticeUniversité ou école supérieure
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CHU Bordeaux Medical Intensive Care Unit pays non établi dans la noticeÉtablissement de santé
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Nord-de-France University Public Health and Quality of Care pays non établi dans la noticeUniversité ou école supérieure
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University Hospital of Lille R. Salengro Hospital pays non établi dans la noticeUniversité ou école supérieure
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University of Lille Nord de France Medical Assessment Laboratory pays non établi dans la noticeUniversité ou école supérieure
Université de Lille, Centre Hospitalier Universitaire de Bordeaux et Université Lille Nord de France, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.