No abstract

Radiographic confirmation of enteral feeding tube placement is a common practice representing considerable expense and causing delay in the initiation of enteral nutrition therapy. We evaluated an enteral feeding tube with a pH sensor, which allows immediate verification of the location of the tube by assessment of the pH upon insertion. Insertion pHs were obtained for 24 intensive care unit patients requiring feeding tube placement. Placement was verified radiographically and compared with expected location on the basis of the pH profile. The radiograph and the insertion pH profile were in agreement in 87.5% (21 of 24) of the cases. Concomitant use of histamine blockers did not affect the ability of the pH sensor to detect placement accurately (Fisher's Exact Test, p 5.71) Use of these pH measurements eliminates the need for radiographic documentation of placement, provides a savings for the patient, and may be beneficial in promoting enteral feedings in critically ill patients.

Further investigation of the use of H1- and H2-blocking agents in the presence of anaphylactoid reactions to thrombolytic agents should be performed. Consideration of intravenous famotidine for the treatment of anaphylactoid-type reactions to urokinase is suggested.