Which of the following statements are true about the potential for aspiration in patients with cuffed tracheal tubes?

1. Periodic oropharyngeal suctioning can help to minimize aspiration.
2. Aspiration is least likely in spontaneously breathing patients.
3. The methylene blue test can help detect leakage-type aspiration.
4. Aspiration is more likely with tracheostomy tubes than with endotracheal tubes.
a. 3 only
b. 1, 2, and 3 only
c. 2 and 4 only
d. 1, 3, and 4 only

ANS: D
Aspiration is reported to be more common in spontaneously breathing patients than in those pa-tients receiving positive-pressure ventilation. This may be due to the movement of pharyngeal secretions around the cuff during the negative-pressure phase of a spontaneous inspiration.