title: A New Modified Evans Blue Dye Test as Screening Test for Aspiration in Tracheostomized Patients.
abstract: OBJECTIVE
  The authors assessed the diagnostic accuracy of a new modified Evans blue dye test (MEBDT) as a screening test for aspiration in tracheostomized patients.
  
  
  METHODS
  Monocentric retrospective study performed between October 2013 and December 2015.
  
  
  METHODS
  Anesthesia and Intensive Care Unit, Second University of Naples.
  
  
  METHODS
  Among 62 eligible patients, 5 were excluded. The authors' study population included 57 patients.
  
  
  METHODS
  Patients underwent both fiberoptic endoscopic examination of the swallow (FEES) and MEBDT to evaluate swallow. The MEBDT results were compared with those of FEES and the diagnostic accuracy of MEBDT was calculated using the FEES as the gold standard.
  
  
  RESULTS
  The authors found that both FEES and MEBDT were positive for aspiration in 40 patients (true-positive MEBDT); FEES and MEBDT were negative in 10 (true-negative MEBDT). On the other hand, FEES was positive with an MEBDT negative in 7 patients (false-negative MEBDT), and there were no FEES negative and MEBDT positive (false-positive MEBDT). MEBDT had a sensitivity, specificity, positive, and negative predicted value of 85%, 100%, 100%, and 58.82%, respectively.
  
  
  CONCLUSIONS
  MEBDT could be a supplementary diagnostic test for aspiration. Patients with positive MEBDT should not undergo oral feeding, while patients with negative MEBDT should undergo FEES before starting oral feeding.
authors.affiliation: Thoracic Surgery Unit, Naples, Italy. Electronic address: alfonso.fiorelli@unina2.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.affiliation: Anaesthesia and Intensive Care Unit, Naples, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Ferraro
authors.affiliation: Anaesthesia and Intensive Care Unit, Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Nagar
authors.affiliation: Anaesthesia and Intensive Care Unit, Naples, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Fusco
authors.affiliation: Otorhinolaringoatric Unit, Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mazzone
authors.affiliation: Department of Radiology, Second University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
authors.affiliation: Thoracic Surgery Unit, Naples, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Di Natale
authors.affiliation: Department of Radiology, Second University of Naples, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Serra
authors.affiliation: Thoracic Surgery Unit, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
mesh_terms: D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005070:Evans Blue / Q000008:administration & dosage* / Q000378:metabolism; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D053120:Respiratory Aspiration / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies; D014139:Tracheostomy / Q000009:adverse effects* / Q000639:trends
chemical_list: D005070:Evans Blue
keywords: fiberoptic endoscopic examination of the swallow; modified Evans blue dye test; tracheostomy