Confirming nasogastric tube position: Methods and restrictions: A narrative review

Rahimi, Masoud; Farhadi, Khosro; Ashtarian, Hossein; Changaei, Frahnaz

doi:10.4103/2345-5756.231420

Cited by 9 publications

(8 citation statements)

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“…In a study by Rahimi et al, the diagnostic percentage of epigastric auscultation was 33.3% in the detection of tube insertion in the lung and 29.2% in gastric tube insertion. These scholars expressed that despite the widespread use of epigastric auscultation, it is not a reliable technique [6]. In spite of a low detection of feeding tube insertion with epigastric auscultation, this method is used [27].…”

Section: Discussionmentioning

confidence: 99%

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The comparison of capnography and epigastric auscultation to assess the accuracy of nasogastric tube placement in intensive care unit patients

et al. 2020

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Background Placement of nasogastric (NG) tubes is a common procedure for patients especially in intensive care units (ICUs). Thus, it is important to determine the correct placement of the tube to prevent misplacement in the airways. Accordingly, the aim of this study was to compare the epigastric auscultation and capnography in assessing the accuracy of NG tube insertion in ICU patients. Methods In this descriptive comparative study, 60 patients were selected trough convenience sampling. After insertion of the NG tube in a standard method, the accuracy of placement of the tube with both epigastric auscultation and capnography was investigated. The NG tube insertion accuracy was then confirmed via radiography. Data analysis was performed using statistical software SPSS version 23. Results The result showed that capnography had a sensitivity, specificity, and accuracy of 100, 92.5, and 95% respectively, but epigastric auscultation had 90, 80, and 83.4% respectively. The Kappa agreement coefficient between two methods was − 0.759. Conclusion The results revealed that the use of the capnography is preferable over the epigastric auscultation to confirm the correct insertion of the NG tube. It is recommended that more than one method be applied to detect and confirm the correct insertion of the NG tube.

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Section: Discussionmentioning

confidence: 99%

“…Typically, one of the most important goals of using these tubes is to supply nutritional needs [5]. Other applications of these tubes include drug therapy and reducing stomach pressure, especially in abdominal operations [6].…”

Section: Introductionmentioning

confidence: 99%

The comparison of capnography and epigastric auscultation to assess the accuracy of nasogastric tube placement in intensive care unit patients

et al. 2020

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“…The length of the NGT to be inserted was determined by measuring the distance from the ipsilateral nostril to the ipsilateral tragus, and further to the xiphoid process. 14,15 Once, the NGT was successfully placed, the cuff of the endotracheal tube was re-inflated.…”

Section: Sample Sizementioning

confidence: 99%

Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone

et al. 2023

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Background: Nasogastric tube (NGT) insertion is an essential procedure in the operating room for which the anesthesiologists often take the responsibility. This simple procedure often becomes difficult in anesthetized patients. Literature reveals the flooding of studies and novel techniques are in the pipeline, indicating that quest for the best is still on. Aims and Objectives: The aim of the study was to determine the proportion of patients in whom successful NGT insertion would be possible in the first attempt using either the “Reverse Sellick’s maneuver (RSM) with throat pack in situ” technique or RSM alone; and to compare the proportions between the two groups. Materials and Methods: This interventional study was performed on 222 adult patients (≥18 years), undergoing abdominal surgeries requiring intraoperative NGT insertion. Patients received NGT insertion using the combined RSM with “throat pack in situ” technique (Group A, n=111) or RSM alone (Group B, n=111). The proportion of patients in whom successful NGT insertion was possible in the first attempt using either of the techniques and the time taken for correct placement of NGT in both the groups. In addition, the incidence of adverse events was noted. Results: Although, NGT placement was possible in higher proportions of patients in Group A in first attempt compared with Group B (91% vs. 83.8%), it was not significant on analysis (P=0.106). The procedure time in both the groups was comparable (30.0±4.0 vs. 29.9±4.3, P=0.859). Coiling was found to be significantly more in the RSM alone technique as compared to the combined method. (P=0.04). Conclusion: With comparable success rate and lesser incidence of adverse events, it can be commented that the RSM with throat pack in situ technique appears to be a better alternative to RSM alone.

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“…Inserting a nasogastric tube (NGT) is a common clinical procedure for critically ill patients (Boeykens et al, 2014; Rahimi et al, 2015). Incorrect placement of the NGT occurs at a rate varying between 1.9% and 89% in adults and can lead to serious complications such as pneumothorax, bronchial aspiration, aspiration pneumonia, oesophageal perforation and oesophageal stenosis as well as morbidity and mortality (Ellett, 2004; Holland et al, 2013; Joseph et al, 2014; Metheny & Meert, 2014, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…However, use of colorimetric capnometry does not provide a distinction between either gastric or intestinal placement and oesophageal placement (Erzincanlı et al, 2017). Therefore, it is suggested that colorimetric capnometry be used in conjunction with the methods of auscultation or pH measurement (Lavillegrand et al, 2015; Rahimi et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of auscultatory, colorimetric capnometry and pH measurement methods to confirm placement of nasogastric tubes: A methodological study

TAŞKIRAN

Sarı

2022

Int J of Nursing Practice

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Aim: To determine the effectiveness of auscultatory, colorimetric capnometry and pH measurement methods for confirmation of correct nasogastric tube placement in critically ill patients.Background: Incorrect nasogastric tube placement causes serious complications.Design: This was a methodological and comparative study. Methods:The study sample consisted of 88 new insertions of nasogastric feeding tubes between April 2018-2019. Results from the 'auscultatory', 'pH' and 'colorimetric capnometry' methods were compared with the location of the nasogastric tube as determined through radiography. Descriptive statistics, Eta analysis and the Cohen kappa compliance test as well as sensitivity and specificity were conducted.Results: There was a weak agreement (26.3%) between the auscultation and radiological evaluation for confirming nasogastric tube placement. The pH measurement and colorimetric capnometry methods were not correlated with radiological evaluation. Stomach pH increased as patient age increased and use of the colorimetric capnometry method failed to confirm the oesophageal and duodenal location. The specificity of the auscultation was low, and both the specificity and sensitivity pH methods were low. Conclusion:It was determined that auscultation, measuring pH and colorimetric capnometry were unreliable methods for confirming placement of nasogastric tubes.It is recommended to confirm initial placement of the nasogastric tube with radiography and to develop effective and reliable non-radiological measurement methods that can be performed at the bedside.

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Confirming nasogastric tube position: Methods and restrictions: A narrative review

Cited by 9 publications

References 0 publications

The comparison of capnography and epigastric auscultation to assess the accuracy of nasogastric tube placement in intensive care unit patients

The comparison of capnography and epigastric auscultation to assess the accuracy of nasogastric tube placement in intensive care unit patients

Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone

The effectiveness of auscultatory, colorimetric capnometry and pH measurement methods to confirm placement of nasogastric tubes: A methodological study

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