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Laboratory and Animal Investigations |

Efficacy of Dye-Stained Enteral Formula in Detecting Pulmonary Aspiration*

Norma A. Metheny, PhD; Thomas E. Dahms, PhD; Barbara J. Stewart, PhD; Kathleen S. Stone, PhD; Sharon J. Edwards, PhD(c); Julie E. Defer, BSN; Ray E. Clouse, MD
Author and Funding Information

*From the School of Nursing (Drs. Metheny and Edwards, and Ms. Defer) and the School of Medicine (Dr. Dahms), Saint Louis University, St. Louis, MO; Oregon Health Sciences University (Dr. Stewart), Portland, OR; Ohio State University (Dr. Stone), Columbus, OH; the Washington University School of Medicine (Dr. Clouse), St. Louis, MO.

Correspondence to: Norma A. Metheny, PhD, Professor, Saint Louis University School of Nursing, 3525 Caroline Mall, St. Louis, Missouri 63104; e-mail: methenna@slu.edu



Chest. 2002;122(1):276-281. doi:10.1378/chest.122.1.276
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Study objective: To determine the extent to which a mixture of human gastric juice and enteral formula stained with two concentrations of FD&C Blue No. 1 food dye (0.8 and 1.5 mL/L) is visible in suctioned tracheobronchial secretions following three forced small-volume pulmonary aspirations over a 6-h period in an animal model.

Design: Experimental 2 × 3 repeated measures.

Setting: Animal laboratory and an acute care hospital.

Participants: Ninety New Zealand white rabbits weighing approximately 3 kg each, and 90 acutely ill adults who furnished gastric juice.

Interventions: A mixture of human gastric juice and enteral formula stained with 0.8 or 1.5 mL of dye per liter was instilled intratracheally over a 30-min period into anesthetized intubated animals at baseline, 2 h, and 4 h. A total of 0.4 mL/kg of the mixture was instilled at each session. Ninety minutes after each instillation, suctioned secretions were examined for visible dye and blood.

Measurements and results: Dye was visible in 46.3% of the secretions (125 of 270). The concentration of dye had no significant effect on dye visibility. Blood that was present in 114 of 270 of the secretions (42.2%) interfered with dye visibility in all but two secretions. For reasons unknown, even in the absence of blood, dye visibility decreased from 90.2% (55 of 61 secretions) after the first aspiration event to only 61% (25 of 41 secretions) after the third aspiration event.

Conclusions: Findings from this animal model study do not support the use of the dye method to detect repeated small-volume aspirations. For clinicians who choose to use the dye method in selected situations, it appears that a dye concentration of 0.8 mL/L may be as effective in detecting aspiration as a 1.5 mL/L concentration.

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