Correlation of Tracheal Amylase and Ventilator-Associated Pneumonia in Mechanically Ventilated Pediatric Patients

Abstract

Introduction: To determine the correlation between tracheal amylase level and ventilator-associated pneumonia (VAP); and evaluate whether tracheal amylase level is associated with pre-intubation aspiration risk factors. Methods: This was a cohort study at Queen Sirikit National Institute of Child Health, Bangkok, Thailand, during April 2019 – March 2020. Intubated and mechanically ventilated pediatric patients aged 1mo – 15 years were included. Tracheal amylase levels were measured at time of enrollment and day of suspected VAP. Results: Tracheal amylase levels were measured at the time of enrollment and on the day of suspected VAP diagnosis. Eighty-eight patients were enrolled in this study, 22 (25%) of which were diagnosed as VAP; and 56 (63.6%) were male. Median initial amylase levels in non-VAP and VAP groups were 165.5 U/L and 108.5 U/L respectively (p=0.82). Median amylase level when VAP was diagnosed decreased to 63 U/L. Median initial amylase level significantly increased in patients with pre-intubation risk factors for aspiration compared to those without (320 U/L and 56 U/L respectively, p < 0.001). Conclusions: There was no association between initial tracheal amylase level and VAP but increased tracheal amylase level was associated with pre-intubation risk factors for aspiration.