3 Points Ultrasonography to Confirm the Correct Position of the Nasogastric Tube in 50 Critically Ill Patients

3点超声检查确认50例危重患者鼻胃管位置正确

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Abstract

PURPOSE: Nasogastric feeding tube is routinely positioned in intensive care units. The complications of misplacement are rare but very dangerous for patients. The aim of this study is to estimate the diagnostic accuracy of this view technique, 3-point ultrasonography to confirm nasogastric tube placement in intensive care. METHODS: Fifty critical ill patients monitored in ICU were included. The intensivist provided in real time to perform the exam in three steps: sonography from either the right or left side of the patient's neck to visualize esophagus, sonography of epigastrium to confirm the passage through the antrum and fundus. Finally, gastric placement of the nasogastric feeding tube was confirmed with thorax radiograph. RESULTS: Fifty of the gastric tubes were visualized by sonography in the digestive tract and all were confirmed by radiography (sensitivity 100%). The entire sonography procedure, including the longitudinal and transversal scan of the esophagus, the esophagogastric junction, the antrum and the fundus, took 10 min. CONCLUSIONS: Our pilot study demonstrated that not weighted-tip gastric tube routinely used in intensive care is visible with the sonography. The pilot study confirmed the high sensitivity of the sonographyin verifying correct positioning of gastric tube in adult ICU patients. The ultrasound examination seems to be easy and rapid even when performed by an intesivist with a sonographic training. The sonographic exam at the bedside was performed in a shorter time than the acquisition and reporting of the X-ray.

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