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Assay of tracheal pepsin as a marker of reflux aspiration

Usha Krishnan1, John D Mitchell, Isabella Messina

  • 1Division of Pediatric Gastroenterology, Sydney Children's Hospital, High Street, Randwick, New South Wales, Australia 2031. usha_krishnan2000@hotmail.com

Journal of Pediatric Gastroenterology and Nutrition
|September 28, 2002
PubMed
Abstract

Insights

Gastric pepsin in tracheal aspirates reliably indicates gastroesophageal reflux aspiration in children. This diagnostic marker is particularly useful for identifying microaspiration in those with respiratory symptoms.

Area of Science:

  • Pediatric Pulmonology
  • Gastroenterology
  • Diagnostic Markers

Background:

  • Aspiration of gastric contents is a common cause of pediatric pulmonary disease.
  • Current diagnostic methods for recurrent aspiration are insufficient.
  • Identifying a reliable marker for microaspiration is crucial.

Purpose of the Study:

  • To evaluate the presence of gastric pepsin in tracheal aspirates as a marker for gastroesophageal reflux (GER) aspiration in children.
  • To determine the diagnostic utility of tracheal pepsin assay in pediatric patients.

Main Methods:

  • Ninety-eight children undergoing general anesthesia were studied.
  • Tracheal aspirates were collected post-intubation.
  • Assay for gastric pepsin using fluoroscein isothiocyanate casein.

Main Results:

  • Pepsin was detected in 31/37 children with both reflux and respiratory symptoms.
  • Pepsin was found in 7/27 children with reflux symptoms and 7/8 with respiratory symptoms.
  • No pepsin was detected in control children without GER or respiratory symptoms.

Conclusions:

  • Tracheal pepsin assay is a reliable marker for diagnosing gastroesophageal reflux aspiration in children.
  • This method shows significant promise for identifying microaspiration, especially in symptomatic patients.

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