气管胃蛋白酶（一种可靠的胃内容物误吸标志物）与机械通气新生儿床头抬高之间的关联。

Association between tracheal pepsin, a reliable marker of gastric aspiration, and head of bed elevation among ventilated neonates.

作者信息

Garland J S, Alex C P, Johnston N, Yan J C, Werlin S L

机构信息

Department of Pediatrics, Wheaton Franciscan Healthcare-St Joseph Hospital, Milwaukee, WI, USA.

Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

J Neonatal Perinatal Med. 2014 Jan 1;7(3):185-92. doi: 10.3233/NPM-14814020.

DOI:10.3233/NPM-14814020

PMID:25318633

Abstract

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.

摘要

目的

确定机械通气新生儿气管内胃蛋白酶的出现频率，以及头部抬高角度是否与气管内胃蛋白酶有关。

研究设计

从插管并接受机械通气的极低出生体重儿中获取系列气管样本（在通气第3、7、14、21和28天）。使用特异性抗人胃蛋白酶抗体通过蛋白质印迹分析确定气管内胃蛋白酶的存在情况。

结果

在66例接受机械通气的新生儿中，有35例（53%）检测到气管内胃蛋白酶（出生体重：798±268克[均值±标准差]）。与首次采样时（第3天）头部抬高处于最低四分位数（≤8度）的新生儿相比，头部抬高处于最高四分位数（≥14度）的新生儿气管内出现胃蛋白酶的可能性较小（4/16比9/10，P=0.0013）。