A survey of bedside methods used to detect pulmonary aspiration of enteral formula in intubated tube-fed patients

BACKGROUND: The most frequently recommended methods to assess for pulmonary aspiration of enteral formula in intubated, tube-fed patients are (1) adding dye to enteral formulas and observing for dye-stained tracheal secretions and (2) testing tracheal secretions with glucose oxidase reagent strips to detect the presence of glucose-rich formula. Reportedly, the glucose method is more sensitive than the dye method, and the dye method may have greater potential for harm. It is not known if this information has resulted in wider use of the glucose method in practice settings. OBJECTIVES: To describe the frequency with which nurses in intensive care units use the dye and glucose methods to detect pulmonary aspiration of enteral formula in tube-fed, intubated patients. METHODS: One registered nurse in the medical intensive care unit at 285 acute-care facilities was contacted by telephone and asked about the methods used to detect pulmonary aspiration of enteral formula in tube-fed, intubated adult patients. RESULTS: Responses were obtained from 281 facilities. More than 73% of the respondents reported using only the dye method; about 1% reported using only the glucose method. Approximately 13% used both methods; another 13% did not use either method. CONCLUSIONS: The dye method is used far more often than is the glucose method. Two probable reasons are that the dye method is easier to implement, and it is recommended in commonly used basic nursing textbooks.