Tracheal amylase: a cheap way to predict ventilator associated pneumonia in patients with traumatic brain injury

Rendón-Ramírez, Erick Joel; Colunga-Pedraza, Perla R.; Herrera-Guerra, Alexis; Cazares-Rendón, Erika; González-Gutiérrez, Adriana; Ahumada-Pamanes, Carolina; Llaca-Díaz, Jorge; Mercado-Longoría, Roberto

doi:10.23736/s0375-9393.19.13884-9

Cited by 2 publications

(6 citation statements)

References 4 publications

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“…In uence analysis and outlier detection (Fig. 6c and 6d) found outlier studies by Rendon's study [20].…”

Section: Sensitivity Analysesmentioning

confidence: 78%

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Value of bronchial amylase level for predicting ventilator associated pneumonia in intubated adults: a systematic review and meta-analysis

Xu,

Shen,

et al. 2023

Preprint

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Background: The ability of bronchial amylase level for predicting ventilator associated pneumonia (VAP) has been extensively studied with conflicting results. This meta-analysis aimed to explore the value of bronchial amylase for predicting VAP in intubated adults. Methods: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched up to November 2023. The diagnostic odds ratio (DOR), sensitivity, and specificity were calculated. The summary receiver operating characteristic curve was estimated, and the area under the curve (AUROC) was calculated. Results: Overall, six studies including 769 patients were included in this review, of whom 273 (36%) were developed VAP. The cutoff values of bronchial amylase level were ranged from 8.1 U/L to 4681.5U/L. Heterogeneity between studies was assessed with an overall Q = 1.99, I2 = 0, and P = 0.185, The pooled sensitivity and specificity for the overall population were 0.78 [95% confidence interval (CI) 0.67–0.86] and 0.75(95% CI 0.56–0.88) respectively. The DOR was 11(95% CI 3.0–40.0). The pooled AUROC was 0.83 (95%CI 0.80 - 0.86). Conclusions: The bronchial amylase is a helpful marker for predicting VAP in intubated adults. However, it cannot be recommended as the single definitive test for VAP, but rather it must be interpreted in context with information from careful medical history, physical examination, and when feasible, microbiological assessment.

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“…In uence analysis and outlier detection (Fig. 6c and 6d) found outlier studies by Rendon's study [20].…”

Section: Sensitivity Analysesmentioning

confidence: 78%

“…After deduplication and precluding irrelevant records, we carefully reviewed the full text of 11 candidate studies. Finally, six studies [10,[19][20][21][22][23] met the eligibility criteria and were included in the quantitative analysis. Figure 1 shows the study selection process.…”

Section: Resultsmentioning

confidence: 99%

Value of bronchial amylase level for predicting ventilator associated pneumonia in intubated adults: a systematic review and meta-analysis

Xu,

Shen,

et al. 2023

Preprint

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“…The median SOFA score in the first 24 hours was 6 points (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) in the VAP group versus 6 (0-14) in the non-VAP group, without a statistically significant difference (P = .49) and the median SOFA score at 48 hours was 6.5 points (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) in the VAP group versus 7 (0-14) in the non-VAP group, without a statistically significant difference (P = .44) (See Table 1). The median APACHE II score in the first 24 hours was 16.5 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) in the VAP group versus 17 in the non-VAP group, without a statistically significant difference (P = .54).…”

Section: Baseline Characteristicsmentioning

confidence: 97%

“…[3,5,17] This marker is inexpensive and easily measured and could be an attractive marker for predicting the development of early VAP. [18]…”

Section: Introductionmentioning

confidence: 99%

“…[3,5,17] This marker is inexpensive and easily measured and could be an attractive marker for predicting the development of early VAP. [18] In the last decade, there has been an increase in thoracic ultrasound (TUS) evaluation in the diagnosis of VAP with almost 100% sensitivity, [19] and few studies have proven the utility of TUS as a tool predictor in detecting lung changes prior to VAP diagnosis. [20] Currently, there are no clinical scores or biomarkers to predict the occurrence of VAP.…”

Section: Introductionmentioning

confidence: 99%

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Thoracic ultrasound alone or in combination with tracheal amylase as a tool predictor of ventilator-associated pneumonia in neurocritical patients

et al. 2022

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In this study, we aim to evaluate whether thoracic ultrasound (TUS) and tracheal amylase (TA) alone or in combination can predict the development of ventilator-associated pneumonia (VAP) in neurocritical patients. Consecutive adult patients with neurocritical disease with normal chest radiographs who required intensive care unit admission and mechanical ventilation between March 2015 and July 2018 were included. TUS and Amylase levels were measured during the first 24 hours and repeated 48 hours after orotracheal intubation. Forty-three patients with a median age of 34 years (17–82) were included. TUS had a sensitivity of 100% and specificity of 96.3% as a predictor of VAP within the first 48 hours when nonpattern A was observed. TA levels > 200 UI/L in the first 48 hours had a sensitivity of 87.5%, and specificity of 63% as a predictor of VAP. Moreover, no benefit of TUS plus TA compared to TUS alone as a predictor of VAP was found. The identification of abnormal TUS patterns in the first 48 hours of orotracheal intubation is a significant predictor of VAP in neurocritical patients.

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Tracheal amylase: a cheap way to predict ventilator associated pneumonia in patients with traumatic brain injury

Cited by 2 publications

References 4 publications

Value of bronchial amylase level for predicting ventilator associated pneumonia in intubated adults: a systematic review and meta-analysis

Value of bronchial amylase level for predicting ventilator associated pneumonia in intubated adults: a systematic review and meta-analysis

Thoracic ultrasound alone or in combination with tracheal amylase as a tool predictor of ventilator-associated pneumonia in neurocritical patients

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