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The accuracy of the modified Evan's blue dye test in detecting aspiration in tracheostomised patients

Published online by Cambridge University Press:  01 April 2019

T A Linhares Filho ,
F P N Arcanjo ,
L H Zanin ,
H A Portela ,
J M Braga  and
V da Luz Pereira
T A Linhares Filho
Affiliation:
Department of Master of Science in Health Sciences, Federal University of Ceará, Sobral, Brazil
F P N Arcanjo*
Affiliation:
Department of Master of Science in Health Sciences, Federal University of Ceará, Sobral, Brazil
L H Zanin
Affiliation:
Department of Phonoaudiology and Physiotherapy, Hospital Regional Norte, Sobral, Brazil
H A Portela
Affiliation:
Department of Phonoaudiology and Physiotherapy, Hospital Regional Norte, Sobral, Brazil
J M Braga
Affiliation:
Department of Phonoaudiology and Physiotherapy, Hospital Regional Norte, Sobral, Brazil
V da Luz Pereira
Affiliation:
Department of Phonoaudiology and Physiotherapy, Hospital Regional Norte, Sobral, Brazil
*
Author for correspondence: Dr Francisco Plácido Nogueira Arcanjo, Av. Comandante Maurocélio Rocha Ponte, 100 – Derby, 62.042-280 – Sobral-CE, Brazil E-mail: franciscoplacidoarcanjo@gmail.com Fax: +55 88 3677 8000
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Abstract

Objectives

To evaluate the sensitivity and specificity of the modified Evans blue dye test compared to the fibre-optic endoscopic evaluation of swallowing to detect aspiration in tracheostomised patients.

Methods

This observational accuracy study included 17 patients hospitalised for respiratory complications, subjected to prolonged intubation, and for this reason, tracheostomised.

Results

Mean patient age was 60.2 ± 21.0 years. Aspiration was identified in 10 patients when assessed by fibre-optic endoscopic evaluation of swallowing; of these, 1 had aspiration when evaluated by modified Evans blue dye test. The dye test had a sensitivity of 10.0 per cent and specificity of 100.0 per cent for detecting aspiration. Fibre-optic endoscopic evaluation of swallowing revealed no statistically significant associations between aspiration presence and: speech and language therapy duration, intubation time, or tracheostomy plus mechanical ventilation duration.

Conclusion

The modified Evans blue dye test is simple and inexpensive, and does not require prior knowledge in endoscopy; it may be used as an initial screening test in all tracheostomised patients for evaluating aspiration. However, fibre-optic endoscopic evaluation of swallowing should be used for a more comprehensive diagnosis of tracheostomy patients, especially for those at high risk for aspiration.

Keywords

DeglutitionTracheostomyEvans BlueEndoscopyAspiration Pneumonia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 4 , April 2019 , pp. 329 - 332
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr F P N Arcanjo takes responsibility for the integrity of the content of the paper

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