Comparison of 3 Methods for Measuring Gastric Tube Length in Newborns

Abstract

Background: Incorrectly positioned gastric tubes occur in approximately 60% of infants hospitalized in the neonatal intensive care unit (NICU), increasing the risk of potentially serious complications. Purpose: To compare 3 methods of determining gastric tube insertion length in infants in the NICU. Methods: In this randomized triple-blind clinical trial, 179 infants admitted to the NICU were randomized to have their gastric tube insertion length determined by 1 of 3 methods: (1) the nose, earlobe, mid-umbilicus (NEMU) method, (2) a weight-based method, or (3) an age-related height-based (ARHB) method. Positioning of the gastric tube was verified by radiograph. R software was used for analyses. To compare categorical variables, Fisher's exact test, χ2 tests, and simulated χ2 tests were used. Results: Overall, infants had a mean gestational age of 35 weeks, 115 (58.8%) were male, and the mean birth weight was 2481.5 g. Upon radiological assessment, 145 gastric tubes (81.3%) were correctly positioned in the gastric body or greater curvature of the stomach with the weight-based method having the highest percentage of correctly positioned gastric tubes (n = 53; 36.6%), followed by the ARHB method (n = 47; 32.4%) and the NEMU method (n = 45; 31.0%). No significant differences were identified between groups (P = .128). Implication for Practice and Research: Despite the NEMU method being the most commonly used method in clinical practice, the weight-based and ARHB methods to determine gastric tube insertion length may be more accurate.

Chat sobre cateterismo gástrico como ferramenta para a aprendizagem em enfermagem pediátrica e neonatal

“…Erros relacionados à técnica de cateterismo gástrico em neonatos, como posicionamento incorreto da sonda, podem gerar complicações como perfurações gastrointestinais que, por sua vez, podem levar o recém-nascido ao óbito (12)(13) . Infelizmente, nota-se que grande parte dos profissionais de enfermagem ainda desenvolve a prática de cateterismo gástrico em desacordo com as recomendações científicas, indícios de falhas no processo de formação e capacitação dos profissionais de enfermagem que atuam na área pediátrica e neonatal (14) .…”

A Nurse-Driven Protocol for Neonatal Enteral Access Device Placement Confirmation

“…The first limitation of this project is that it may not be able to be generalized to other clinical settings since it was a QI project. In addition, other insertion measurement techniques (age-related height-based, weight-based), other modalities of gastric pH measurement, (capnography, point-of-care ultrasound, and other technologies) for placement confirmation, were not included in the project because they were not included in the consensus recommendations but are discussed in the literature 21,22. Due to the Institutional Review Board restrictions, nurses who were not validated on the protocol were included in the data collection, thereby impacting compliance.…”