title: Scintigraphy for evaluating early aspiration after oral feeding in patients receiving prolonged ventilation via tracheostomy.
abstract: OBJECTIVE
  In tracheotomised patients the incidence of aspiration is difficult to determine because investigators often apply different criteria. In this study a scintigraphic method was used to visualise feeding aspiration directly and the results were compared with clinical evidence of aspiration.
  
  
  METHODS
  Prospective study in difficult-to-wean patients with tracheostomy.
  
  
  METHODS
  Respiratory ICU.
  
  
  METHODS
  The study population consisted of 62 consecutive patients (16 females, age: 64.1+/-11.1 years). All patients were tracheotomised and had previously been long-term ventilated in other ICUs due to weaning failure. The scintigraphic test was performed during spontaneous breathing. The standard nutrition consisted of a liquid, semi-liquid and solid meal which was labelled with 100 MBq 99mTc-human serum albumin.
  
  
  RESULTS
  Scintigraphic aspiration (SA) was defined as positive if radioactivity was detected in the bronchial system using a scintillation camera. Furthermore, aspiration was proven clinically (CA). CA and SA yielded identical results in 54 of the 62 patients [10 positive (16%) and in 44 negative (71%)]. CA, but not SA, was seen in 4/62 (6.5%) and SA, but not CA, was found in 4/62 (6.5%) patients.
  
  
  CONCLUSIONS
  Our data re-emphasise that aspiration in tracheotomised patients is common (in our study approximately 30%). The scintigraphic method failed to identify all tracheotomised patients with clinically significant aspiration; however, it did suggest that some patients had subclinical aspiration.
authors.affiliation: Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, Schmallenberg-Grafschaft, Germany. bernd.schoenhofer@t-online.de
authors.forename: B
authors.initials: B
authors.lastname: Schönhofer
authors.forename: T
authors.initials: T
authors.lastname: Barchfeld
authors.forename: P
authors.initials: P
authors.lastname: Haidl
authors.forename: D
authors.initials: D
authors.lastname: Köhler
mesh_terms: D000368:Aged; D005248:Feeding Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012121:Respiration, Artificial / Q000009:adverse effects; D014139:Tracheostomy / Q000009:adverse effects