Potential Risk of Malposition of Nasogastric Tube Using Nose-Ear-Xiphoid Measurement

Yen-Chun Chen, Lien-Yen Wang, Yu-Jun Chang, Chao-Pin Yang, Tsung-Ju Wu, Fung-Ru Lin, Sen-Yung Liu and Ta-Sen Wei

PLOS ONE, 2014, vol. 9, issue 2, 1-7

Abstract: Background: Correct placement of nasogastric tubes provide proper functionality and maximize benefit and minimize risk. The Nose-Ear-Xiphoid (NEX) body surface estimate method is a long-lasting technique, and this study was conducted to evaluate the correlation between NEX method and the secure insertion depth of nasogastric tube. Materials and Methods: Thirty patients with nasogastric tube insertion who received whole body positron emission tomography with computerized tomography scan (PET-CT) were recruited. All data were gathered in the image center, which included Nose-Ear (NE), Ear-Xiphoid (EX), Nose-Ear-Xiphoid (NEX), glabella-xiphoid (GX) and glabella-umbilicus (GU) lengths. The distances of the inserted portion of the nasogastric tube between the cardiac and the nostril were measured by multiplanar reconstruction algorithm. Results: Only one patient successfully placed all side-holes into the stomach while using NEX method to estimate inserting depth. Twenty-nine patients (96.7%) failed to place correctly. Fourteen participants had one or more side-holes in both the esophagus and the stomach sides. Fifteen patients could not pass through any side-hole across the gastroesophageal junction. They had shorter EX distances (p = 0.02), but no difference among the NE distances. Body height had the highest statistical correlation with nasogastric tube length (adjusted R2 = 0.459), as compared with the NEX, GX and GU body surface methods. Conclusion: This study suggests that NEX method is inappropriate for adult patients to estimate the ideal inserting length of nasogastric tube. Physicians should realize these underinsertions with any side-hole above the gastroesophageal junctions may increase the potential risk of complications.

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0088046

DOI: 10.1371/journal.pone.0088046

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