A STUDY OF ALPHA-AMYLASE ACTIVITY IN TRACHEOBRONCHIAL SECRETIONS OF SERIOUSLY ILL PATIENTS WITH TRACHEOSTOMIES

This study was undertaken to assess any salivary aspiration in serious ly 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 secr etions 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 stud y. Six out of 15 patients showed very high levels of alpha-amylase act ivity in their tracheobronchial secretions on Day 3 and all six subseq uently developed severe chest infections. The other nine patients show ed a low level of amylase activity in their secretions. Two patients i n the latter group developed severe pulmonary disease. This study demo nstrates that a high level of alpha-amylase activity in the tracheobro nchial secretions of tracheotomized, ventilated patients indicates tha t salivary aspiration may be taking place, and further suggests that p rogressively increasing levels may indicate the likelihood of a major pulmonary complication developing.