Is FD&C Blue Dye #1 safe for use in enteral feeds?
Recently there have been reports of FD&C Blue dye No. 1 causing skin discoloration, metabolic acidosis, and hypotension. Zillich et al describe an 11-year-old girl who appeared severely cyanotic the day after enteral feeding was started. The patient was found to have normal respiration and all laboratory tests were negative. The patient’s hands, face, and feet as well as her urine, stool, and serum were noted to be blue-green in color. The enteral feeding was stopped after it was noted to be a deep blue color. A new enteral feeding bag without dye was started. The blue-green discoloration of the child’s skin disappeared over the next 24 hours. No additional complications were noted. The authors estimated that the child ingested 20-100 ml of FD&C Blue dye No. 1, which equated to 780-3940 mg of the dye over an 8-12 hour period. Maloney et al described 2 cases of refractory hypotension and acidosis in patients who were receiving FD&C Blue dye No. 1. The first patient was a 54-year-old man
