Hyperamylasemia in patients at an intensive care unit

We have evaluated the prevalence of hyperamylasemia in various acute disorders that required admission to an intensive care unit. Hyperamylasemia was found in 27 of 53 patients (51%). The source of hyperamylasemia was determined by isoamylase analysis with an inhibition method using an inhibitor specific to salivary type isoamylase. Increased pancreatic type isoamylase with a high P/S ratio was found in six patients with disorders related to the pancreas and elevated salivary type isoamylase with a low P/S ratio in 17 with various extrapancreatic diseases of heart, lung, trauma, or in the postoperative state. We found a simultaneous rise in pancreatic and salivary type isoamylases with normal P/S ratio in four patients with renal failure. Our experience suggests that isoamylase analysis by an inhibition method can be done rapidly and inexpensively. Knowing whether hyperamylasemia is pancreatic or nonpancreatic in origin should help to exclude unnecessary evaluation and treatment.