DOES PULSE OXIMETRY RELIABLY DETECT ASPIRATION IN DYSPHAGIC STROKE PATIENTS

Background and Purpose The aim of the present study was to examine the value of pulse oximetry in the diagnosis of aspiration by comparing i t with the gold standard, videofluoroscopy, by use of a prospective, c ontrolled, single-blind study design. Methods Pulse oximetry was perfo rmed simultaneously with videofluoroscopy in 54 consecutive dysphagic stroke patients. Oxygen saturation measurements were taken before the videofluoroscopic examination (baseline), on swallowing and continuous ly for 2 minutes after swallowing, and 10 minutes later. Results Pulse oximetry reliably predicted aspiration or lack of it in 81.5% of case s. The predictive value of the test was low in patients aged greater t han or equal to 65 years and possibly those with chronic lung disease. One smoker also had a false-negative pulse oximetry result, ie, norma l oxygen saturation despite radiological evidence of aspiration. Concl usions Pulse oximetry is a reliable method of diagnosis of aspiration in most dysphagic patients. However, careful interpretation of pulse o ximetry data is necessary in older subjects, possibly those with chron ic pulmonary disease, and smokers. The method is noninvasive, simple, and quick, and can be used routinely in the clinical assessment of dys phagic patients.