ArticlePloS one2014
Accuracy of alpha amylase in diagnosing microaspiration in intubated critically-ill patients.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 47 citations in OpenAlex.
- Research on Effects of Oropharyngeal Aspiration on Incidence of Ventilator-Associated Pneumonia in Patients with Cerebral Hemorrhage in ICU.Journal of healthcare engineering · 2022Trial
- Intubation Setting, Aspiration, and Ventilator-Associated Conditions.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2020Trial
- Impact of deep oropharyngeal suctioning on microaspiration, ventilator events, and clinical outcomes: A randomized clinical trial.Journal of advanced nursing · 2019Trial
- Nursing oral suction intervention to reduce aspiration and ventilator events (NO-ASPIRATE): A randomized clinical trial.Journal of advanced nursing · 2019Trial
- Impact of tapered-cuff tracheal tube on microaspiration of gastric contents in intubated critically ill patients: a multicenter cluster-randomized cross-over controlled trial.Intensive care medicine · 2017Trial
- Trial
- Airway tracers and biomarkers for aspiration detection and VAP prediction in ICU patients with tracheal tubes: a systematic review and diagnostic accuracy meta-analysis.Annals of intensive care · 2026Review
- Utility ofERJ open research · 2025Article
- Machine learning predictive model for aspiration risk in early enteral nutrition patients with severe acute pancreatitis.Heliyon · 2024Article
- Intratracheal Amylase Levels and Salivary Aspiration in Children with Tracheostomy.JMA journal · 2024Article
- Accuracy of the Infectious Diseases Society of America and British Thoracic Society Criteria for Acute Pneumonia in Differentiating Chemical and Bacterial Complications of Aspiration in Comatose Ventilated Patients Following Drug Poisoning.Antibiotics (Basel, Switzerland) · 2024Article
- Use of an innovative cuff pressure control and subglottic secretions drainage system in COVID-19 ARDS patients undergoing pronation.Critical care (London, England) · 2022Article
- Are Cirrhotic Patients Receiving Invasive Mechanical Ventilation at Risk of Abundant Microaspiration.Journal of clinical medicine · 2022Article
- Association of enteral feeding with microaspiration in critically ill adults.Applied nursing research : ANR · 2022Article
- Pepsin A in Tracheal Secretions From Patients Receiving Mechanical Ventilation.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2021Article
- Is COPD associated with increased risk for microaspiration in intubated critically ill patients?Annals of intensive care · 2021Article
- Transesophageal echocardiography-associated tracheal microaspiration and ventilator-associated pneumonia in intubated critically ill patients: a multicenter prospective observational study.Critical care (London, England) · 2020Observational
- Is α-Amylase an Important Biomarker to Detect Aspiration of Oral Secretions in Ventilated Patients?Critical care explorations · 2020Article
- Impact of nutrition route on microaspiration in critically ill patients with shock: a planned ancillary study of the NUTRIREA-2 trial.Critical care (London, England) · 2019Article
- Impact of subglottic secretion drainage on microaspiration in critically ill patients: a prospective observational study.Annals of translational medicine · 2018Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAmylase concentration in respiratory secretions was reported to be a potentially useful marker for aspiration and pneumonia. The aim of this study was to determine accuracy of α-amylase in diagnosing microaspiration in critically ill patients.
methodsRetrospective analysis of prospectively collected data collected in a medical ICU. All patients requiring mechanical ventilation for at least 48 h, and included in a previous randomized controlled trial were eligible for this study, provided that at least one tracheal aspirate was available for α-amylase measurement. As part of the initial trial, pepsin was quantitatively measured in all tracheal aspirates during a 48-h period. All tracheal aspirates were frozen, allowing subsequent measurement of α-amylase for the purpose of the current study. Microaspiration was defined as the presence of at least one positive tracheal aspirate for pepsin (>200 ng.mL-1). Abundant microaspiration was defined as the presence of pepsin at significant level in >74% of tracheal aspirates.
resultsAmylase was measured in 1055 tracheal aspirates, collected from 109 patients. Using mean α-amylase level per patient, accuracy of α-amylase in diagnosing microaspiration was moderate (area under the receiver operator curve 0.72±0.05 [95%CI 0.61-0.83], for an α-amylase value of 1685 UI.L-1). However, when α-amylase levels, coming from all samples, were taken into account, area under the receiver operator curve was 0.56±0.05 [0.53-0.60]. Mean α-amylase level, and percentage of tracheal aspirates positive for α-amylase were significantly higher in patients with microaspiration, and in patients with abundant microaspiration compared with those with no microaspiration; and similar in patients with microaspiration compared with those with abundant microaspiration. α-amylase and pepsin were significantly correlated (r2 = 0.305, p = 0.001).
conclusionAccuracy of mean α-amylase in diagnosing microaspiration is moderate. Further, when all α-amylase levels were taken into account, α-amylase was inaccurate in diagnosing microaspiration, compared with pepsin.
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