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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: [email protected] 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

References

1Simão, MA, Alacid, CAN, Rodrigues, KA, Albuquerque, C, Furkim, AM. Incidence of tracheal aspiration in tracheostomized patients in use of mechanical ventilation. Arq Gastroenterol 2009;46:311–14Google Scholar
2Brady, SL, Hildner, CD, Hutchins, BF. Simultaneous videofluoroscopic swallow study and modified Evans blue dye procedure: an evaluation of blue dye visualization in cases of known aspiration. Dysphagia 1999;14:146–9Google Scholar
3Belafsky, PC, Blumenfeld, L, Lepage, A, Nahrstedt, K. The accuracy of the modified Evan's blue dye test in predicting aspiration. Laryngoscope 2003;113:1969–72Google Scholar
4Ajemian, MS, Nirmul, GB, Anderson, MT, Zirlen, DM, Kwasnik, EM. Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management. Arch Surg 2001;136:434–7Google Scholar
5Warnecke, T, Suntrup, S, Teismann, IK, Hamacher, C, Oelenberg, S, Dziewas, R. Standardized endoscopic swallowing evaluation for tracheostomy decannulation in critically ill neurologic patients. Crit Care Med 2013;41:1728–32Google Scholar
6Winklmaier, U, Wust, K, Plinkert, PK, Wallner, F. The accuracy of the modified Evans blue dye test in detecting aspiration in head and neck cancer patients. Eur Arch Otorhinolaryngol 2007;264:1059–64Google Scholar
7Thompson-Henry, S, Braddock, B. The modified Evan's blue dye test procedure fails to detect aspiration in the tracheostomized patient: five case reports. Dysphagia 1995;10:172–4Google Scholar
8Donzelli, J, Brady, S, Wesling, M, Craney, M. Simultaneous modified Evans blue dye procedure and video nasal endoscopic evaluation of the swallow. Laryngoscope 2001;111:1746–50Google Scholar
9Meyers, AD. The modified Evan's blue dye procedure in the tracheostomized patient. Dysphagia 1995;10:175–6Google Scholar
10Langmore, SE, Schatz, K, Olsen, N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988;2:216–19Google Scholar
11Hiss, SG, Postma, GN. Fiberoptic endoscopic evaluation of swallowing. Laryngoscope 2003;113:1386–93Google Scholar
12Aviv, JE, Murry, T, Zschommler, A, Cohen, M, Gartner, C. Flexible endoscopic evaluation of swallowing with sensory testing: patient characteristics and analysis of safety in 1.340 consecutive examinations. Ann Otol Rhinol Laryngol 2005;114:173–6Google Scholar
13Langmore, SE, Schatz, K, Olson, N. Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol 1991;100:678–81Google Scholar
14Cameron, JL, Reynolds, J, Zuidema, GD. Aspiration in patients with tracheostomies. Surg Gynecol Obstet 1973;136:68–70Google Scholar
15Terk, AR, Leder, SB, Burrell, MI. Hyoid bone and laryngeal movement dependent upon presence of a tracheotomy tube. Dysphagia 2007;22:89–93Google Scholar