{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:28:03Z","timestamp":1790742483152,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Aspiration pneumonia is the most common respiratory complication following out-of-hospital cardiac arrests (OHCA). Alpha-amylase (\u03b1-amylase) in pulmonary secretions is a biomarker of interest in detecting inhalation. The main goal of this study is to evaluate the performance of bronchoalveolar levels of \u03b1-amylase in early diagnosis of aspiration pneumonia, in patients admitted to intensive care unit (ICU) after OHCA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective single-center trial, led during 5 years (July 2015 to September 2020). We included patients admitted to ICU after OHCA. A protected specimen bronchial brushing and a mini-bronchoalveolar lavage (mini-BAL) were collected during the first 6 h after admission. Dosage of bronchial \u03b1-amylase and standard bacterial analysis were performed. Investigators confirmed pneumonia diagnosis using clinical, radiological, and microbiological criteria. Every patient underwent targeted temperature management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>88 patients were included. The 34% (30 patients) developed aspiration pneumonia within 5 days following admission. The 55% (17) of pneumonias occurred during the first 48 h. The 57% of the patients received a prophylactic antibiotic treatment on their admission day. ICU mortality was 50%. Median value of bronchial \u03b1-amylase did not differ whether patients had aspiration pneumonia (15 [0\u201394]) or not (3 [0\u201361], <jats:italic>p<\/jats:italic> = 0,157). Values were significantly different concerning early-onset pneumonia (within 48 h) [19 (7\u2013297) vs. 3 (0\u201382), <jats:italic>p<\/jats:italic> = 0,047]. If one or more microorganisms were detected in the initial mini-BAL, median value of \u03b1-amylase was significantly higher [25 (2\u2013230)] than in sterile cultures (2 [0\u201343], <jats:italic>p<\/jats:italic> = 0,007). With an 8.5 IU\/L cut-point, sensitivity and specificity of \u03b1-amylase value for predicting aspiration pneumonia during the first 2 days were respectively 74 and 62%. True positive and negative rates were respectively 44 and 86%. The area under the ROC curve was 0,654 (CI 95%; 0,524\u20130,785). Mechanical ventilation duration, length of ICU stay, and mortality were similar in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our study, dosage of bronchial \u03b1-amylase was not useful in predicting aspiration pneumonia within the first 5 days after ICU admission for OHCA. Performance in predicting early-onset pneumonia was moderate.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.880803","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T14:54:41Z","timestamp":1652453681000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Salivary Alpha Amylase Bronchial Measure for Early Aspiration Pneumonia Diagnosis in Patients Treated With Therapeutic Hypothermia After Out-of-hospital Cardiac Arrest"],"prefix":"10.3389","volume":"9","author":[{"given":"Anis","family":"Moussali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Cauchois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Carvelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Hraeich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fouad","family":"Bouzana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Lesaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Boucekine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandine","family":"Bichon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Gainnier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Fromonot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Bourenne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00134-021-06368-4","article-title":"European resuscitation council and european society of intensive care medicine guidelines 2021: post-resuscitation care","volume":"47","author":"Nolan","year":"2021","journal-title":"Intensive Care Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1097\/CCM.0b013e3182120b56","article-title":"Infectious complications in out-of-hospital cardiac arrest patients in the therapeutic hypothermia era","volume":"39","author":"Mongardon","year":"","journal-title":"Crit Care Med. 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