Methods of Estimating Nasogastric Tube Length: All, Including "NEX," Are Unsafe.
Nutr Clin Pract
; 35(5): 864-870, 2020 Oct.
Article
en En
| MEDLINE
| ID: mdl-32406552
ABSTRACT
BACKGROUND:
Predominance of blind feeding tube placement makes esophageal tube misplacement and aspiration risk commonplace. Accurate estimation of nose-to-stomach length could reduce this risk. Standards for estimating this length were audited against the length measured from guided tube placement.METHODS:
This prospective, single-center observational study used electromagnet-guided tube placement to measure the length from nose to gastric body flexure as part of routine care. This measurement was used to audit standard equations used to estimate this length from externalmeasures:
xiphisternum-ear-nose + 10 cm (XEN+10), nose-ear-xiphisternum (NEX), and Hanson_A and Hanson_B.RESULTS:
From April 23, 2015, to March 2, 2020, measurements were obtained from 200 primary tube placements. Median length to the gastric body flexure (61 cm) was significantly different from that to the pre-gastroesophageal junction flexure (48 cm) or lengths predicted by NEX (51 cm) or Hanson_A (50.5 cm) and Hanson_B (56.1 cm) (all P < .00001) but similar to XEN+10 (61 cm). Esophageal placement was a potential risk for all methods (NEX 96.3%, Hanson_A 99.5%, Hanson_B 86.9%, XEN+10 43.2%) and a definite risk for most (NEX and Hanson_A 14.9%, Hanson_B 1%, XEN+10 0%).CONCLUSIONS:
NEX and Hanson methods of predicting the length from nose to gastric body flexure are too short and risk esophageal misplacement. XEN+10 reduces but does not eliminate this risk. External measurement predictions are clinically unsafe as a guide blind tube placement. Guided placement is recommended.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
Problema de salud:
1_doencas_nao_transmissiveis
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2_muertes_prematuras_enfermedades_notrasmisibles
Asunto principal:
Intubación Gastrointestinal
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Nutr Clin Pract
Asunto de la revista:
CIENCIAS DA NUTRICAO
/
ENFERMAGEM
Año:
2020
Tipo del documento:
Article
País de afiliación:
Reino Unido