• Alfonso Fiorelli, Fausto Ferraro, Francesca Nagar, Pierluigi Fusco, Salvatore Mazzone, Giuseppe Costa, Davide Di Natale, Nicola Serra, and Mario Santini.
• Thoracic Surgery Unit, Naples, Italy. Electronic address: alfonso.fiorelli@unina2.it.
• J. Cardiothorac. Vasc. Anesth. 2017 Apr 1; 31 (2): 441-445.

ObjectiveThe authors assessed the diagnostic accuracy of a new modified Evans blue dye test (MEBDT) as a screening test for aspiration in tracheostomized patients.DesignMonocentric retrospective study performed between October 2013 and December 2015.SettingAnesthesia and Intensive Care Unit, Second University of Naples.ParticipantsAmong 62 eligible patients, 5 were excluded. The authors' study population included 57 patients.InterventionsPatients 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.Measurements And Main ResultsThe 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.ConclusionsMEBDT 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.Copyright © 2017 Elsevier Inc. All rights reserved.

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