Metheny N A, Aud M A, Wunderlich R J
Saint Louis University School of Nursing, Mo., USA.
Am J Crit Care. 1999 May;8(3):160-7; quiz 168-9. doi: 10.1177/088453360001500113.
The most frequently recommended methods to assess for pulmonary aspiration of enteral formula in intubated, tube-fed patients are (1) adding dye to enteral formulas and observing for dye-stained tracheal secretions and (2) testing tracheal secretions with glucose oxidase reagent strips to detect the presence of glucose-rich formula. Reportedly, the glucose method is more sensitive than the dye method, and the dye method may have greater potential for harm. It is not known if this information has resulted in wider use of the glucose method in practice settings.
To describe the frequency with which nurses in intensive care units use the dye and glucose methods to detect pulmonary aspiration of enteral formula in tube-fed, intubated patients.
One registered nurse in the medical intensive care unit at 285 acute-care facilities was contacted by telephone and asked about the methods used to detect pulmonary aspiration of enteral formula in tube-fed, intubated adult patients.
Responses were obtained from 281 facilities. More than 73% of the respondents reported using only the dye method; about 1% reported using only the glucose method. Approximately 13% used both methods; another 13% did not use either method.
The dye method is used far more often than is the glucose method. Two probable reasons are that the dye method is easier to implement, and it is recommended in commonly used basic nursing textbooks.
对于插管并接受管饲的患者，评估肠内营养制剂发生肺误吸最常推荐的方法有两种：（1）在肠内营养制剂中添加染料，观察气管分泌物是否被染色；（2）用葡萄糖氧化酶试纸检测气管分泌物，以检测富含葡萄糖的营养制剂是否存在。据报道，葡萄糖法比染料法更敏感，且染料法可能具有更大的潜在危害。目前尚不清楚这些信息是否已导致葡萄糖法在实际应用中得到更广泛的使用。
描述重症监护病房护士使用染料法和葡萄糖法检测管饲插管患者肠内营养制剂肺误吸的频率。
通过电话联系了285家急症护理机构的医疗重症监护病房的一名注册护士，询问其用于检测管饲插管成年患者肠内营养制剂肺误吸的方法。
收到了来自281家机构的回复。超过73%的受访者报告仅使用染料法；约1%的受访者报告仅使用葡萄糖法。约13%的受访者同时使用两种方法；另有13%的受访者两种方法都不使用。
染料法的使用频率远高于葡萄糖法。两个可能的原因是染料法更容易实施，且常用的基础护理教科书中也推荐使用该方法。
