Clinical Laboratory Improvement Amendments (CLIA) Lab
We are a CLIA-certified laboratory located in Wilmington, Delaware. The GI Clinical Lab, a part of the Gastroenterology Laboratory at Nemours, provides the following tests:
Disaccharidase Determination
Small Bowel Biopsy
The activity of disaccharidases, including lactase, maltase, sucrase, palatinase and glucoamylase, can be determined from an intestinal biopsy with approximately 2 to 5 mg wet weight. Avoid contamination with traces of the fixative used for surgical pathology biopsies. Upon collection, the specimen should be placed in a small, tightly capped, plastic tube and immediately frozen on dry ice or stored in a freezer at -20°C to -70°C (no automatic defrost cycles). The biopsy should not be placed on gauze or a toothpick, nor should any solutions be added. The sample should be shipped with enough dry ice to remain frozen. Enzyme activity may be affected if the sample thaws.
Pancreatic Enzyme Activities
Duodenal Aspirate
Amylase, lipase, trypsin, chymotrypsin and elastase activities can be determined from duodenal fluid. A minimum of 0.2 ml fluid is required to analyze the five enzymes, protein content, and pH. The sample can be a single fluid or multiple fluids. The fluid should be placed in a small, tightly capped, plastic tube. Keep the sample frozen and ship on dry ice.
Gastric Pepsin Assay
Gastric pepsin detected in the airway of patients is a specific and sensitive marker to assess pulmonary aspiration. The GI Clinical Lab at Nemours offers a sensitive, reliable enzymatic test to detect gastric pepsin in the airway samples. The assay has high specificity as it detects pepsin A that is exclusively expressed in the gastric mucosa. For more information on the research studies that used the assay or a similar enzymatic assay, please see the References listed below.
Collecting Airway Aspirate
To collect tracheal secretion: Attach a LUKI trap to a suction catheter, pass the catheter down the endotracheal tube, and apply suction to the catheter as the catheter is withdrawn. If the secretion is too thick to be withdrawn, instill saline (2 cc) to the tracheal tube prior to aspirating the secretion.
To collect bronchial secretion: Bronchial secretion can be collected using a standard collection protocol. Collect 1-2 cc bronchial washing fluid in a plain specimen tube.
Please avoid over-diluting the secretion with a large amount of saline during the collection. A minimum of 0.5 cc fluid is required to determine gastric pepsin activity, protein content, and pH. The airway fluid should be transferred to a small, tightly capped, plastic tube and frozen immediately after collection. Keep sample frozen and ship on dry ice.