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Diagnostic methods for the detection of anterograde aspiration in enterally fed patients

Gomes, Guilherme F; Campos, Antonio C; Pisani, Julio C; Macedo, Evaldo D; Vieira, Mario C

Current Opinion in Clinical Nutrition & Metabolic Care: May 2004 - Volume 7 - Issue 3 - p 285-292
Pharmaceutical aspects, devices and techniques

Purpose of review The diagnosis of aspiration and its origin in patients on enteral tube feeding is challenging to the physician and provides an important means to prevent pneumonia. This review examines the most recent studies and developments in the field with an approach to the technical aspects of diagnostic methods.

Recent findings The methods more commonly used to detect anterograde aspiration in clinical practice are fiberoptic endoscopic evaluation of swallowing and modified barium swallowing. Recent studies have shown that although these methods may provide the diagnosis of aspiration, their use for clinical monitoring is not appropriate. The studies comparing fiberoptic endoscopic evaluation of swallowing and modified barium swallowing have demonstrated that both tests present similar sensitivity, specificity and predictive values.

Summary The different methods used to diagnose anterograde aspiration are appropriate for clinical practice, with a low complication rate and few contraindications. In most instances, the early diagnosis of aspiration and evaluation of other factors such as laryngeal sensibility, may predict the occurrence of aspiration pneumonia.

Departments of Gastroenterology and Surgery, Federal University of Parana and Hospital Nossa Senhora das Graças, Curitiba, Brazil

Correspondence to Antonio C. Campos, MD, PhD, Department of Surgery, Federal University of Parana, Rua Comendador Araujo, 143, cj 113, 80420-000, Curitiba (PR), Brazil E-mail: accampos@hc.ufpr.br

© 2004 Lippincott Williams & Wilkins, Inc.