Saturday August 11, 2007
Blue dye in tube feedings

Although initially thought to be without risk and a reasonable indicator of aspiration, the nutritional support community advises AGAINST putting blue dye into tube feeds. Blue dye was thought to be non-absorbable, non-toxic, and sensitive for aspiration. However, now it is hypothesized that blue dye can be absorbed systemically due to increased intestinal permeability and that it can cause decreased mitochondrial oxygen consumption and mitochondrial toxicity.

ASPEN (American Society of Parenteral and Enteral Nutrition) recommends against the use of blue dye in tube feeds. The reasons include:

● The reliability and validity have not been adequately tested.
● There have been reports of skin and body organ staining.
● No safe amount of dye has been established.

Since blue dye is NOT recommended to routinely detect aspiration, prevention is the best treatment. Prevention may include:

● Adjusting rate of administration based on tolerance, bowel sounds, and residuals.
● Elevating the head of bed 45 degrees or more.
● Pro-motility agents.




References: click to get abstract/article

1. Use of Colored Dyes in Enteral Formulas. REVIEW ARTICLE - Topics in Clinical Nutrition. 21(3):226-233, July/September 2006
2. Systemic absorption of food dye in patients with sepsis. N Engl J Med 2000;343(14):1046-7.
3. Skin discoloration with blue food coloring. Ann Pharmacother 2000;34:868-70.
4. Evidence-based practice for enteral feedins:aspiration prevention strategies, bedside detection, and practice changes. Medsurg Nurs 2000;9(1):27-31.