Dextrose Swallowing Test to Detect Aspiration for Patient with Tracheostomy

ABSTRACT

OBJECTIVE: To evaluate the usefulness of 10% dextrose swallowing test (DST) to detect aspiration for patient with tracheostomy in comparison with modified blue dye test (MBDT). METHOD: Fifteen brain injured patients with tracheostomy were tested by DST and MBDT. The newly developed DST consists of 3 steps. In the first step, 5 cc 10% dextrose solution is fed 3 times by spoon. In the second step, tracheal secretion is sampled by suction catheter just before swallowing, and 30 seconds, 90 seconds after swallowing. In the third step, tracheal secretion is smeared to glucose oxidase test strip to detect aspiration with color change from pink to purple. MBDT with 0.01 % methylene blue solution was also performed in the same order. The tracheal secretion was smeared to the white paper to see the color change to blue. Videofluoroscopic swallowing study (VFSS) was performed for 9 out of 15 patients. RESULTS: Fourteen out of 15 patients showed the same outcome in DST and MBDT (kappa=0.815). Seven out of 9 patients showed the same outcome in DST and VFSS (kappa=0.571). Eight out of 9 patients showed the same outcome in MBDT and VFSS (kappa=0.780). CONCLUSION: The DST is a reliable method to detect aspiration for patient with tracheostomy.