Prospective trial comparing a combination pH probenasogastric tube with aspirated gastric pH in intensive care unit patients

Eisenberg, Patricia; Cort, David; Zuckerman, Gary R.

doi:10.1097/00003246-199010000-00008

Cited by 12 publications

(5 citation statements)

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“…Previous investigations have shown that electrode catheter-determined pH might not always reflect in vitro pH electrode-determined aspirate pH and that this variability also applies to indicator paper-based determinations [9,10,12-14]. Potential reasons for the observed variability between methods are many but probably involve regional variability of intragastric pH, contact of the electrode with the mucosa, and others.…”

Section: Discussionmentioning

confidence: 99%

Validation of the RightSpot™ device for determination of gastric pH during nasogastric tube placement

et al. 2013

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BackgroundThe RightSpotpH™ indicator is a new device designed to facilitate pH-based confirmation of nasogastric tube placement while minimizing exposure of the operator to nasogastric contents. Study objectives: In vivo and in vitro validation of the RightSpotpH™ indicator.FindingsPatients (23) undergoing general anesthesia had placement of a nasogastric tube and gastric pH electrode catheter following endotracheal intubation. Direct intragastric pH was recorded simultaneously with gastric aspirate pH using the RightSpotpH™ indicator as well as an external pH electrode. In vitro validation of the RightSpotpH™ indicator was performed using standard buffer solutions. Electrode catheter-determined intragastric pH was compared to the RightSpotpH™ indicator result (pH greater or less than 4.5) as was aspirate pH using an external pH electrode. The positive predictive value for the RightSpotpH™ indicator was 0.92 (95% CI 0.62-0.99) and negative predictive value was 1.0 (95% CI 0.48-1.0) when compared to the direct catheter intragastric pH determination. This corresponds to a sensitivity of 1.0 and specificity of 0.83. The positive predictive value for the RightSpotpH™ indicator was 1.0 (95% CI 0.29-0.99) and negative predictive value was 0.75 (95% CI 0.19-0.99) when compared to the external pH electrode determination of aspirate. This corresponds to a sensitivity of 0.91 and specificity of 1.0. Blinded in vitro testing of 46 buffer solution samples of pH 2–7 yielded sensitivity and specificity for correct pH discrimination of 1.0 and 1.0.ConclusionsThe RightSpotpH™ indicator is sensitive and specific for determination of intragastric pH determination as less than or greater than 4.5 as commonly used for nasogastric tube placement.

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Section: Discussionmentioning

confidence: 99%

Validation of the RightSpot™ device for determination of gastric pH during nasogastric tube placement

et al. 2013

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“…(9) The gold standard for gastric pH measurement is the pH electrode measurement, however, this method is described as "cumbersome, labor-intensive and expensive" (Dobkin et al, 1990[4]; Eisenberg, Cort, & Zuckerman, 1990 [6]). Consequently, gastric secretion pH measurements have traditionally been tested using pH paper.…”

Section: Summary Of Researchmentioning

confidence: 99%

“…(10) The introduction of a combination of a pH probe-nasogastric tube provides an accurate and reliable method of pH measurement (Durham & Weigelt, 1989[5]; Neill, Rice, & Ahern, 1993 [16]; Eisenberg, Cort, & Zuckerman, 1990 [6]). Advantages of this method include: (1) decreased handling of gastric juices with decreased exposure to potentially infectious agents; (2) ease of measurement; (3) ability to obtain frequent pH readings; (4) ability to measure pH even in the presence of low gastric volumes; (5) reduction in the number of tubes inserted into the stomach; (6) improved patient comfort; (7) possibility of decreased tube-related esophagitis, and (8) ability to provide both long-term pH monitoring and gastric feeding/decompression (Eisenberg et al, 1990[6]).…”

Section: Summary Of Researchmentioning

confidence: 99%

Feeding Tube Placement Verification Using Gastric pH Measurement

Chen

Paxton

Williams-Burgess

1996

Worldviews on Evidence-based Nursing presents the archives of O

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The importance of nutrition in hospitalized patients cannot be underestimated. Proper nutrition is necessary for wound healing, recovery, reduction in morbidity, and consequent reductions in lengths of stay and mortality. Enteral nutrition, preferred over parenteral nutrition because of decreased bacterial translocation and reduced expense, is frequently delivered via a feeding tube. However, improper position of the feeding tube may result in pulmonary aspiration. Many of the methods currently employed in the verification of feeding tube placement are unreliable.

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“…In conjunction with risk factors for bleeding, increasing acidity in the gastric mucosal pH can be predictive of mortality in critically ill patients (Doglio, Pusajo, Egurrola, et al, 1991[11]; Fiddian-Green, 1993 [15]). (14) The decreasing incidence of significant gastric bleeding is due in part to prophylactic therapy. The standard of practice in critical care units is to administer prophylactic medications to patients at risk of stress ulcers (Cook, Witt, Cook, & Guyatt, 1991 [8]).…”

Section: Summary Of Researchmentioning

confidence: 99%