A study of alpha-amylase activity in tracheobronchial secretions of seriously ill patients with tracheostomies.

This study was undertaken to assess any salivary aspiration in seriously ill patients with tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheobronchial secretions of 15 such patients were analysed to evaluate the incidence of salivary aspiration. None of the patients had clinical or radiological evidence of lung disorder at the time of the commencement of the study. Six out of 15 patients showed very high levels of alpha-amylase activity in their tracheobronchial secretions on Day 3 and all six subsequently developed severe chest infections. The other nine patients showed a low level of amylase activity in their secretions. Two patients in the latter group developed severe pulmonary disease. This study demonstrates that a high level of alpha-amylase activity in the tracheobronchial secretions of tracheotomized, ventilated patients indicates that salivary aspiration may be taking place, and further suggests that progressively increasing levels may indicate the likelihood of a major pulmonary complication developing.