Confirmation of nasogastric tube placement in critical care

Moore, Michael C.; Thomson, Rebekah

doi:10.1186/cc12182

Cited by 2 publications

(3 citation statements)

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“…In our study, the time took to obtain confirmatory chest radiographs was about 235 min. The findings were similar to those of Moore et al [18], who took 220 min in the ICU setting to confirm NGT using chest radiographs.…”

Section: Discussionsupporting

confidence: 89%

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Point-of-care ultrasonography-assisted nasogastric tube placement in the emergency department: a randomized controlled trial

Mohd.

Kumar

Bhoi

et al. 2022

European Journal of Emergency Medicine

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BackgroundThe complications of a blind procedure for gastric tube placement are well documented. POCUS has been widely used to confirm the position of blindly inserted gastric tubes, and it does not prevent complications caused by the blind method. We performed a randomized controlled trial to compare gastric tube insertion with real-time oesophagus visualization using POCUS to the standard technique.Objective The primary goal of this study was to compare the accuracy of real-time POCUS-guided nasogastric tube (NGT) insertion and confirmation to that of the standard technique.Methods It was a prospective, parallel-group, openlabel randomized controlled trial with a superiority design. All patients requiring NGT were screened for inclusion and exclusion criteria, and 120 patients were randomly assigned to one of two groups: POCUS (n = 60) or control (n = 60). Following the procedures, confirmatory chest radiographs were obtained in both groups. ResultsAs per protocol, 118 patients were analyzed. In POCUS group, the oesophagus was visualized on POCUS in 56 of 58 patients (96.5%). In 55 of 58 cases (94.8%), an NGT was inserted in real time. Despite visualizing the oesophagus, we fail to insert the tube in one (1.8%). The oesophagus could not be seen on the scan in two cases (3.4%). Chest radiographs confirmed the tube in the stomach in 55 (98.2%). The chest radiograph revealed the tip of the NGT in the stomach in 52 of 60 (86.6%) patients. In seven cases (11.7%), we were unable to insert NGT. On a chest radiograph, one (1.6%) tip of the tube was seen in the right lung and was safely removed. The ultrasound-guided gastric tube insertion had a sensitivity of 96.5% (95% CI, 88-99.6%) and a positive predictive value (PPV) of 98.2% (95% CI, 98.1-98.3%). The conventional technique had 88% (95% CI, 77-95%) sensitivity and a PPV of 98% (95% CI, 97.9-98.2%). ConclusionPOCUS enables real-time insertion of a gastric tube with high sensitivity, in a short time with high first-attempt success rate and limited passagerelated complications. POCUS should be utilized for NGT insertion whenever expertise is available on the bedside.

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Section: Discussionsupporting

confidence: 89%

“…The findings were similar to those of Moore et al . [18], who took 220 min in the ICU setting to confirm NGT using chest radiographs. Using POCUS for NGT insertion eliminates the need for a confirmatory chest radiograph, saving time in an emergency situation.…”

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasonography-assisted nasogastric tube placement in the emergency department: a randomized controlled trial

Mohd.

Kumar

Bhoi

et al. 2022

European Journal of Emergency Medicine

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“…Another audit was done by M Moore and R Thomson in NHS trust, London. 13 According to them, tube placement was confirmed by X-ray (72%) and pH of aspirates (35%). Methodology used by majority in our audit is different from them.…”

Section: Discussionmentioning

confidence: 99%

LOCAL AUDIT OF PRACTICES OF NG FEEDING IN ACCORDANCE TO THE NICE-NUTRITIONAL SUPPORT GUIDELINES 2006 & BSG 2003

Khan¹,

Khalid²

2018

Pak Postgrad Med J.

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OBJECTIVES: To compare practice of NG feeding in our hospital with standard protocols & suggest improvements. AIM: 1. To promote a clear, consistent and evidenced based approach to the placement, care and management of nasogastric tubes. 2. To promote the safety and well-being of all patients who require a nasogastric tube. SAMPLE: Health care professionals (staff nurses, House Officers , Medical Officers, Post graduate Trainees) working in Ward, ICU & HDU of LGH during the month of June 2015, were recruited to participate in this study. DATA SOURCE: Performa based AUDIT TYPE: Health care professionals Surve

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Confirmation of nasogastric tube placement in critical care

Cited by 2 publications

References 0 publications

Point-of-care ultrasonography-assisted nasogastric tube placement in the emergency department: a randomized controlled trial

Point-of-care ultrasonography-assisted nasogastric tube placement in the emergency department: a randomized controlled trial

LOCAL AUDIT OF PRACTICES OF NG FEEDING IN ACCORDANCE TO THE NICE-NUTRITIONAL SUPPORT GUIDELINES 2006 & BSG 2003

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