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Journal of Clinical Monitoring and Computing

, Volume 31, Issue 2, pp 443–448 | Cite as

To characterize the incidence of airway misplacement of nasogastric tubes in anesthetized intubated patients by using a manometer technique

  • Shao-Wei Hsieh
  • Hung-Shu Chen
  • Yi-Ting Chen
  • Kuo-Chuan HungEmail author
Original Research

Abstract

This study characterized the incidence of airway misplacement of nasogastric (NG) tubes in surgical patients, and the benefit of using a manometer to discriminate gastric placement from airway placement of NG tubes. Subjects included adult patients scheduled for abdominal surgery. After tracheal intubation, a 16 Fr. NG tube was inserted blindly through the nostril, and its position was assessed using the auscultation (10-ml air insufflation) or manometer (attached to NG tubes) techniques. Briefly, a biphasic pressure change synchronous with airway pressure during mechanical ventilation indicated airway misplacement. The presence of a notable pressure change while compressing the epigastric area indicated a gastric placement. A surgeon made the final confirmation of NG tube placement within the stomach using manual palpation of the tube immediately after laparotomy. The first-attempt success rate was 82.7 % in 104 patients. There were 29 misplacements of 130 attempted insertions (oral cavity, n = 23; trachea, n = 3; distal esophagus, n = 3). The incidence of airway misplacement was 2.9 % (3 of 104 cases). For confirmation of gastric placement, the auscultation technique had a sensitivity of 100.0 % and a specificity of 79.3 %. In contrast, the manometer technique had a sensitivity of 100.0 % and a specificity of 100.0 % in the discrimination of gastric placement from airway placement of NG tubes. Airway misplacement of NG tubes is not uncommon in surgical patients, and the manometer technique may be a reliable and safe method to discriminate gastric placement from airway placement of NG tubes.

Keywords

Nasogastric tube Manometer Tracheal tube Pneumothorax 

Notes

Acknowledgments

The authors would like to thank Enago (www.enago.tw) for the English language review.

Compliance with ethical standards

Conflict of interest

All contributing authors declare no conflicts of interest.

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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Shao-Wei Hsieh
    • 1
  • Hung-Shu Chen
    • 1
  • Yi-Ting Chen
    • 1
  • Kuo-Chuan Hung
    • 1
    Email author
  1. 1.Department of AnesthesiologyE-DA HospitalKaohsiungTaiwan, ROC

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