经机械通气的埃及足月新生儿胃食管反流病的发生与气管内吸出物胃蛋白酶的检测。

Amira Elrefaee, Abdel-Rahman A Abdel-Razek, Zeinab S Abdelkhalek, Peter Samaan, Amir Fawzy Kamal
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引用次数: 0

摘要

背景:胃食管反流病(GERD)在新生儿中很常见,特别是那些需要机械通气的新生儿。胃蛋白酶是一种可靠的胃误吸标志物,可能有助于检测通气新生儿的GER发作并评估相关的临床结果。目的:通过检测气管内吸入物(ETA)中的胃蛋白酶,确定足月机械通气新生儿胃食管反流的发生率、相关危险因素和发病率。方法:本研究纳入了2023年4月至2024年3月在开罗大学医院新生儿重症监护病房住院的97例足月新生儿。ETA样本在三个时间间隔采集:插管后立即(样本A)、插管后48小时(样本B)和拔管前(样本C)。采用酶联免疫吸附法测定胃蛋白酶浓度。临床数据,包括住院时间和喂养参数,与胃蛋白酶水平相关。结果:A、B、c分别有76例(78.4%)、78例(81.3%)和47例(68.1%)检出胃蛋白酶。B、B、c中胃蛋白酶水平与FiO2呈显著正相关(r = 0.203, P = 0.047)。延长住院时间也与B、C样品胃蛋白酶检测相关(P < 0.05)。饲食量与胃蛋白酶水平呈显著负相关(P < 0.05)。结论:足月机械通气新生儿胃食管反流发生率高,与胃酶水平、FiO2、喂养不耐受、住院时间有关,早期发现的重要性突出。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Incidence of gastro-esophageal reflux disease in mechanically ventilated full-term Egyptian neonates by detection of pepsin in endotracheal aspirate.

Incidence of gastro-esophageal reflux disease in mechanically ventilated full-term Egyptian neonates by detection of pepsin in endotracheal aspirate.

Background: Gastroesophageal reflux disease (GERD) is common among neonates, particularly those requiring mechanical ventilation. Pepsin, a reliable marker of gastric aspiration, may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.

Aim: To determine the incidence of GERD, associated risk factors, and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endotracheal aspirates (ETA).

Methods: This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024. ETA samples were collected at three intervals: Immediately post-intubation (Sample A), 48 hours after intubation (Sample B), and just before extubation (Sample C). Pepsin concentration was measured using enzyme-linked immunosorbent assay. Clinical data, including hospital stay duration and feeding parameters, were correlated with pepsin levels.

Results: Pepsin was detected in 76 (78.4%) of Sample A, 78 (81.3%) of Sample B, and 47 (68.1%) of Sample C. A significant positive correlation was found between pepsin levels and FiO2 in Sample B (r = 0.203, P = 0.047). Prolonged hospital stay was also associated with pepsin detection in Samples B and C (P < 0.05). A negative correlation was observed between feeding amount and pepsin levels across all samples (P < 0.05).

Conclusion: The incidence of GERD in full-term mechanically ventilated neonates is high, correlating with pepsin levels, FiO2, feeding intolerance, and hospital stay, highlighting the importance of early detection.

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