Critical care nutrition: reducing the risk of aspiration

While aspiration is a fairly common event for critically ill patients on enteral tube feeding, progression to aspiration pneumonia is difficult to predict due to variation in host factors and characteristics of the aspirate material. Aspiration of oropharyngeal secretions is of equal if not greater importance than aspiration of gastric contents. Monitors for aspiration such as glucose oxidase, blue food coloring, and gastric residual volumes are insensitive and unreliable. A number of clinical risk factors can be identified at the bedside. A variety of management strategies may be used in the intensive care unit to reduce risk of aspiration, while efforts continue to provide sufficient volume of enteral nutrients.