Diagnosis of Microaspiration in Intubated Critically Ill Patients: Pepsin vs 99m Technetium

Diagnosis of Microaspiration in Intubated Critically Ill Patients: Pepsin vs 99m Technetium

Microaspiration of contaminated oropharyngeal secretions and gastric contents frequently occurs in intubated critically ill patients, and plays a major role in the pathogenesis of ventilator-associated pneumonia. Quantitative pepsin measurement in tracheal aspirates would be useful in diagnosing microaspiration of gastric contents in intubated critically ill patients. Technetium 99m labelled enteral feeding is the gold standard for the diagnosis of microaspiration. The investigators hypothesized that tracheal pepsin measurement is a good diagnosis marker of microaspiration compared to the gold standard.

Microaspiration of contaminated oropharyngeal secretions and gastric contents frequently occurs in intubated critically ill patients, and plays a major role in the pathogenesis of ventilator-associated pneumonia Quantitative pepsin measurement in tracheal aspirates would be useful in diagnosing microaspiration of gastric contents in intubated critically ill patients Technetium 99m labelled enteral feeding is the gold standard for the diagnosis of microaspiration. We hypothesized that tracheal pepsin measurement is a good diagnosis marker of microaspiration compared to the gold standard

Inclusion Criteria:

• age > or = 18 years
• hospitalised in ICU
• tracheal intubation using a polyvinyl chloride tube and mechanical ventilation
• predictable mechanical ventilation > or = 6 hours after inclusion
• enteral nutrition by a nasogastric tube

Exclusion Criteria:

• refuse to participate to the study
• no informed consent
• pregnant
• contra-indication for enteral nutrition
• tracheotomy
• intubation or re-intubation done in 6 hours preceding the inclusion