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


RESULTS
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.


CONCLUSIONS
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.
Gomes
Guilherme F
GF
Department of Gastroenterology, Federal University of Parana and Hospital Nossa Senhora das Graças, Curitiba, Brazil.
Campos
Antonio C
AC
Pisani
Julio C
JC
Macedo
Evaldo D
ED
Vieira
Mario C
MC
D001464:Barium; D003680:Deglutition Disorders / Q000175:diagnosis; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D004750:Enteral Nutrition; D006801:Humans; D001239:Inhalation; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D001464:Barium