Association between tracheal pepsin, a reliable marker of gastric aspiration, and head of bed elevation among ventilated neonates. J Neonatal Perinatal Med 2014 Jan 01;7(3):185-92
Date
10/17/2014Pubmed ID
25318633DOI
10.3233/NPM-14814020Scopus ID
2-s2.0-84909981710 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
OBJECTIVES: To determine the frequency of tracheal pepsin in ventilated neonates and whether the angle of head elevation was associated with tracheal pepsin.
STUDY DESIGN: Serial trachael samples (at 3, 7, 14, 21 and 28 days of ventilation) were obtained from intubated, ventilated very low birth weight infants. Presence of tracheal pepsin was determined by Western blot analysis using a specific anti-human pepsin antibody.
RESULTS: Tracheal pepsin was detected in 35/66 (53%) of the ventilated neonates (birthweight: 798 ± 268 grams [mean ± standard deviation]). Neonates whose head elevation was in the upper quartile (≥14 degrees) during the first sampling time (day 3) were less likely (4/16 vs 9/10, P = 0.0013) to have tracheal pepsin when compared to neonates whose head elevation was in the lowest quartile (≤8 degrees).
CONCLUSIONS: Pepsin, a marker for gastric secretion aspiration, was detected in 53% of ventilated low birth weight neonates; early elevation of the head of the bed was associated with a lower rate of tracheal pepsin.
Author List
Garland JS, Alex CP, Johnston N, Yan JC, Werlin SLAuthor
Nikki Johnston PhD Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
BedsBiomarkers
Blotting, Western
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Patient Positioning
Pepsin A
Pneumonia, Aspiration
Pneumonia, Ventilator-Associated
Prospective Studies
Respiration, Artificial
Respiratory Aspiration of Gastric Contents
Trachea
Treatment Outcome
