Pulse oximetry does not reliably detect aspiration on videofluoroscopic swallowing study.
OBJECTIVE
To examine the reliability of pulse oximetry for identifying aspiration by comparing it with the videofluoroscopic swallowing study (VFSS).


METHODS
Nonrandomized, prospective, double-blind study.


METHODS
VFSS laboratory in a teaching hospital.


METHODS
Sixty patients from among 130 patients with clinically diagnosed dysphagia between September and December 2002.


METHODS
Not applicable.


METHODS
Simultaneously monitoring the arterial oxygen saturation (Sp o 2 ) by pulse oximetry while patients were performing VFSS. A decrease in Sp o 2 exceeding 3% was considered as significant desaturation. Bolus or portion of bolus passing through the vocal cords and entering the subglottic space was defined as aspiration on VFSS. The results of pulse oximetry and VFSS were compared.


RESULTS
No significant correlation existed between desaturation measured by pulse oximetry and aspiration on VFSS (chi 2 test, P =.87). The positive predictive rate of pulse oximetry in detecting aspiration on VFSS was 39.1%, and the negative predictive rate was 59.4%.


CONCLUSIONS
Aspiration occurring on VFSS cannot be predicted based on decrease in Sp o 2 in pulse oximetry. The application of pulse oximetry to detect aspiration during regular meals requires further investigation.
Wang
Tyng-Guey
TG
Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, College of Medicine, and National Taiwan University, Taipei. tgw@ha.mc.ntu.edu.tw
Chang
Yeun-Chung
YC
Chen
Ssu-Yuan
SY
Hsiao
Tzu-Yu
TY
D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology; D004311:Double-Blind Method; D006801:Humans; D001239:Inhalation; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications
D010100:Oxygen