Q I have heard there is controversy in using blue dye in enteral tube feedings as a method of detecting pulmonary aspiration. Our institution is still using it. What does the latest evidence show?

A James Maloney, MD, and Norma Metheny, RN, PhD, reply: ______

Yes, there is controversy. This practice of adding blue dyes (usually FD&C Blue No. 1 food dye) to tint enteral feedings is common. In a 1999 survey of 281 US intensive care units, 86% of nurses reported using the blue dye method regularly.1 The rationale behind the method assumes that it is safe and effective (sensitive and specific) for detecting aspiration. The practice has never been reviewed or approved by the Food and Drug Administration. Like many hospital practices, the blue dye method was widely embraced based on assumptions and intuitive appeal, not based on results of clinical trials. Few studies were performed to...

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