Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T02:17:15.297Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  29 June 2007

V. Nandapalan
Affiliation:
Departments of Otolaryngology, Royal Liverpool University Hospital, Prescot, Merseyside.
J. C. McIlwain*
Affiliation:
Departments of Otolaryngology, Liverpool and Whiston Hospital, Prescot, Merseyside.
J. Hamilton
Affiliation:
Departments of Otolaryngology, Royal Liverpool University Hospital, Prescot, Merseyside.
*
Mr J. C. McIlwain, Department of Otorhinolaryngology, Whiston Hospital, Prescot, Merseyside L35 5DR. Fax: 0151 430 1094

Abstract

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

ABPI Data Sheet Compendium (19941995), Datapharm Publications Ltd, London, p 1826.Google Scholar
Alessi, D. M., Berci, G. (1986) Aspiration and nasogastric intubation. Otolaryngology – Head and Neck Surgery 94: 486489.CrossRefGoogle ScholarPubMed
Amberson, J. B. (1937) Aspiration bronchopneumonia. International Clinics 3: 126138.Google Scholar
Argov, S., Goldstein, I., Barzilai, A. (1980) Is routine use of the nasogastric tube justified in upper abdominal surgery? American Journal of Surgery 139: 849850.CrossRefGoogle ScholarPubMed
Arms, R. A., Dines, D. E., Tinstman, T. C. (1974) Aspiration pneumonia. Chest 65: 136139.CrossRefGoogle ScholarPubMed
Bartlett, J. G, Gorbach, S. L. (1975) The triple threat of aspiration pneumonia. Chest 68: 560566.CrossRefGoogle ScholarPubMed
Bonanno, P. C. (1970) Swallowing dysfunction after tracheostomy. Annals of Surgery 174: 29.CrossRefGoogle Scholar
Cameron, J. L., Zuidema, G. D. (1972) Aspiration pneumonia: magnitude and frequency of the problem. Journal of the American Medical Association 219: 11941196.CrossRefGoogle ScholarPubMed
Cameron, J. L., Mitchell, W. H., Zuidema, C. D. (1973a) Aspiration pneumonia, clinical outcome following documented aspiration. Archives of Surgery 106: 4952.CrossRefGoogle ScholarPubMed
Cameron, J. L., Reynolds, I, Zuidema, C. D. (1973b) Aspiration in patients with tracheostomies. Surgery, Gynaecology and Obstetrics 136: 6870.Google ScholarPubMed
Clarke, P. D., Bain, B. C, Davies, A., Levin, G. E., Lambert, H. P. (1981) Aspiration in seriously ill patients: a study of amylase in bronchial secretion. Journal of Clinical Pathology 34: 803805.CrossRefGoogle Scholar
Harada, K., Kitamura, M. (1971) Amylase isoenzyme in a patient with primary bronchial carcinoma. Medicine and Biology 82: 155158.Google Scholar
Luhr, H. (1951) Die Erhohung des glykolytischen Ferments Diatase in Serum bei Bronchial karzinom als Fruhsymptom. Munchener Medizinische Wochenschrift 93: 24072408.Google Scholar
Nandapalan, V., Mcllwain, J. C, England, J. (1995) Amylase activity in tracheobronchial secretions of laryngectomized patients. Journal of Laryngology and Otology 109: 637639.CrossRefGoogle ScholarPubMed