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

Journal of Neonatal-Perinatal Medicine

Volumn 7, Issue 3, 2014, Pages 185-192

  Garland, Jeffery S ^a   Alex, C P ^a   Johnston, N ^b   Yan, J C ^b   Werlin, S L ^b  

^a Wheaton Franciscan Healthcare St Joseph's Hospital   (United States)

^b MEDICAL COLLEGE OF WISCONSIN   (United States)

Author keywords

Aspiration; Gastroesophageal reflux; Ventilator associated pneumonia; Very low birth weight infants

Indexed keywords

BIOLOGICAL MARKER; PEPSIN A; PEPSINOGEN; TRACHEAL PEPSIN; UNCLASSIFIED DRUG;

ARTICLE; ARTIFICIAL VENTILATION; BIRTH WEIGHT; CHRONIC LUNG DISEASE; COHORT ANALYSIS; CONTROLLED STUDY; GASTRIC SUCTION; GESTATIONAL AGE; HOSPITAL BED; HOSPITALIZATION; HUMAN; MAJOR CLINICAL STUDY; MECHANICAL VENTILATOR; NEONATAL VENTILATOR; NEWBORN; NEWBORN DISEASE; PROSPECTIVE STUDY; TRACHEAL ASPIRATION PROCEDURE; VENTILATED PATIENT; VENTILATOR ASSOCIATED PNEUMONIA; VERY LOW BIRTH WEIGHT; WESTERN BLOTTING; BED; CLINICAL TRIAL; COMPLICATION; INFANT, PREMATURE, DISEASES; METABOLISM; MULTICENTER STUDY; NEWBORN INTENSIVE CARE; PATIENT POSITIONING; PNEUMONIA, ASPIRATION; PNEUMONIA, VENTILATOR-ASSOCIATED; PREMATURITY; PROCEDURES; RESPIRATORY ASPIRATION OF GASTRIC CONTENTS; TRACHEA; TREATMENT OUTCOME;

BEDS; BIOLOGICAL MARKERS; 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;

EID: 84909981710     PISSN: 19345798     EISSN: 18784429     Source Type: Journal    
DOI: 10.3233/NPM-14814020     Document Type: Article

References (28)

1. Ewer AK, Durbin GM, Morgan MEI, Booth IW. Gastric emptying and gastro-oesophageal reflux in preterm infants. Arch Dis Child Fetal Neonatal Ed 1996;75:F117-21.
2. Newell SA, Booth IW, Morgan ME, Durbin GM, Mcneish AS. Gastro-oesophageal reflux in preterm infants. Arch Dis Child 1989;64:780-6.
3. Omari TI, Barnett C, Snel A et al. Mechanisms of gastroesophageal reflux in healthy premature infants. J Pediatr 1998;133:650-54.
4. Omari TI, Barnett CP, Benninga MA et al. Mechanisms of gastro-oesophageal reflux in preterm and term infants with reflux disease. Gut 2002;51:475-79.
5. Farhath S, Aghai ZH, Nakhla T et al. Pepsin, a reliable marker of gastric aspiration, is frequently detected in tracheal aspirates from premature ventilated neonates: Relationship with feedings and methylxanthine therapy. JPGN 2006;43:336-41.
6. Farhath S, He Z, Nakhla T et al. Pepsin, a marker of gastric contents, is increased in tracheal aspirates from preterm infants who develop bronchopulmonary dysplasia. Pediatrics 2008:121;e253-e59.
7. Krishnan U, Mitchell JD, Messina I, Day AS, Bohane TD. Assay of tracheal pepsin as a marker of reflux aspiration. JPGN 2002;35:303-308.
8. Armand M, Hamosh M, Mehta NR, Angelus PA et al. Effect of human milk or formula on gastric function and fat digestion in the premature infant. Pediatric Research 1996;40:429-37.
9. Metheny NA, Chang Y-H, Ye JS et al. Pepsin as a marker for pulmonary aspiration. Am J Crit Care 2002;11:150-54.
10. Garland JS. "Strategies to prevent ventilator-associated pneumonia in neonates." in Clin Perinatol 2010;37:629-43.
11. CDC NNIS System national nosocomial infection surveillance system report, data summary from january 1992 through june 2004, issued October 2004. Am J Infect Control 2004;32:475-80.
12. O'Grady NP, Murray PR, Ames N. Preventing ventilator-associated pneumonia. does the evidence support the practice. JAMA 2012;307:2534-39.
13. Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogue S, Ferrer M. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: A randomized trial. Lancet 1999;354:1851-58.
14. Kollef MH. Ventilator-associated pneumonia: A multivariate analysis. JAMA 1993;270:1965-70.
15. Van Nieuwenhoven CA, Vandenbroucke-Grauls C, van Tiel FH, Joore HC, van Schijndel RJ, van der Tweel. Feasiblility and effects of the semi-recumbent position to prevent ventilator-associated pneumonia: A romdomized study. Crit Care Med 2006;34:396-402.
16. GE Healthcare Giraffe Omnibed Specifications. http://www3.gehealthcare.com/en/Products/Categories/Maternal-Infant-Care. May 19,2014.
17. Centers for Disease Control and Prevention. Criteria for defining nosocomial pneumonia. http://www.cdc.gov/ncidod/hip/NNIS/members/pneumonia/final/PneuCriteriaFinal.pdf Accessed March 15, 2010.
18. Axford SE, Sharp N, Ross PE et al. Cell biology of laryngeal epithelial defenses in health and disease: Preliminary studies. Ann Otol Rhinol Laryngol 2001;110:1099-1108.
19. Crapko M, Kerschner J, and Johnston N. Role of extraesopahgeal reflux in chronic otitis media with effusion. Laryngoscope 2007; 117(8):1419-23.
20. Elabiad MT, Zhang J. Detection of pepsinogen in the neonatal lung and stomach by immunohistochemistry. JPGN 2011;53:401-403.
21. Meert KL, Daphtary KM, Methany NA. Detection of pepsin and glucose in tracheal secretions as indicators of aspiration in mechanically ventilated children. Pediatr Crit Care Med 2002; 3:19-22.
22. Spray SB, Zuidema GD, Cameron JL. Aspiration pneumonia: Incidence of aspiration with endotracheal tubes. Am J Surg 1976;131:701-703.
23. Young PJ, Basson C, Hamilton D, Ridley, SA. Prevention of tracheal aspiration using the pressure-limited tracheal tube cuff. Anaesthesia 1999; 54:559-63.
24. Tablan, OC, Anderson LJ, Besser, R, Bridges C, Hajjeh R. Guidelines for preventing health-care-associated pneumonia, 2003. recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR 2004;53(RR03):1-36.
25. Mouterde O, Dacher JN, Basuyau JP, Mallet E. Gastric secretion in infants. Application to the study of sudden infant death syndrome and apparently life-threatening events. Biol Neonate 1992; 62:15-22.
26. Gharpure V, Meert KL, Sarnaik AP, Metheny NA. Indicators of post-pyloric feeding tube placement in children. Crit Care Med 2000;28:2962-66.
27. Kelly EA, Parakininkas DE, Werlin SL, Southern JF, Johnston N, Kershcner JE. Utilization of pepsin as a biomarker to assess prevalence of pediatric aspiration associated extra-esphogeal reflux disease. American Society of Pediatric Otolaryngology Annual Meeting, 2013. Arlington, Virginia.
28. Aly H, Badawy M, El-Kholy A, Nabil R, Mohamed A. Randomized, controlled trial on tracheal colonization of ventilated infants: Can gravity prevent ventilator-assoicated pneumonia? Pediatrics 2008;122:770-74.