Ufberg Jacob W, Bushra Joseph S, Karras David J, Satz Wayne A, Kueppers Friedrich
Department of Emergency Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA.
Am J Emerg Med. 2005 May;23(3):379-82. doi: 10.1016/j.ajem.2005.02.005.
We prospectively compared the incidence of pulmonary aspiration of gastric contents between patients endotracheally intubated in the prehospital (PH) setting and those intubated in the emergency department (ED). Tracheal aspirates were collected using a standard Leukens trap from all patients as soon as possible after endotracheal intubation. Tracheal aspirates were then tested for the presence of pepsin, a sensitive and specific marker of gastric contents, using a fibrinogen digestion technique. Over 8 months, 168 patients were enrolled. The pepsin assay was positive in 10 of 20 (50%) patients intubated in the PH group, as opposed to 33 of 148 (22%) of those intubated in the ED (chi2 P=.008; odds ratio, 3.5; 95% CI, 1.34-9.08). Patients endotracheally intubated in the PH setting are more likely to have aspirated gastric contents than those intubated in the ED.
我们前瞻性地比较了在院前（PH）环境中接受气管插管的患者与在急诊科（ED）接受插管的患者胃内容物肺误吸的发生率。气管插管后，尽快使用标准的Leukens收集器从所有患者中采集气管吸出物。然后，采用纤维蛋白原消化技术检测气管吸出物中胃蛋白酶的存在，胃蛋白酶是胃内容物的一种敏感且特异的标志物。在8个月的时间里，共纳入了168例患者。PH组20例患者中有10例（50%）胃蛋白酶检测呈阳性，而ED组148例患者中有33例（22%）呈阳性（χ²检验P = 0.008；优势比为3.5；95%可信区间为1.34 - 9.08）。在PH环境中接受气管插管的患者比在ED中接受插管的患者更有可能发生胃内容物误吸。
