• J Esparza, M A Boivin, M F Hartshorne, and H Levy.
• Division of Pulmonary/Allergy/Critical Care Medicine, Department of Internal Medicine, University Hospital, University of New Mexico, 2211 Lomas Blvd. NE, Albuquerque, NM 87131-5721, USA.
• Intensive Care Med. 2001 Apr 1; 27 (4): 660-4.

ObjectivesTo determine the difference in aspiration rates between gastrically and transpylorically fed patients in the intensive care unit.DesignA prospective controlled study of critically ill patients randomized to receive either a gastrically placed feeding tube or a transpylorically placed feeding tube.SettingUniversity teaching hospital's medical intensive care unit. The study was conducted over 14 months.PatientsFifty-four critically ill subjects (with an overall 40% mortality) with similar baseline age, severity of illness, and nutritional needs requiring enteral nutrition, with 51 completing the study.InterventionsAll feeds were tagged with technetium-99m radiolabeled sulfur colloid, and the pulmonary secretions or lungs of each patient were scanned on a daily basis to determine whether aspiration had occurred. Patients were fed according to their assigned tube placement which was verified daily by continuous electromyography.Measurements And ResultsOf 27 gastrically fed patients 2 (7%) had evidence of scanned feed in pulmonary secretions or the lung, compared to 3 of 24 (13%) transpylorically fed patients (n.s.). Clinical suspicion of aspiration was insensitive and detected only 60% of isotopically documented aspirations with a positive predictive value of 27%.ConclusionThere was no difference in aspiration rates between gastrically and transpylorically fed critically ill patients.

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