The Use of Ultrasonography for Verifying Gastric Tube Placement in Newborns

Adv Neonatal Care. 2019 Jun;19(3):219-225. doi: 10.1097/ANC.0000000000000553.

Abstract

Background: The use of gastric tubes in newborns admitted to a neonatal intensive care unit is fairly high, and there is a risk of serious complications related to this procedure.

Purpose: Considering the need to find a method that does not involve the patient's exposure to radiation, this study aimed to evaluate the diagnostic accuracy of ultrasonography for verifying gastric tube placement in newborns.

Methods: This was a prospective, double-blind, observational study performed in a neonatal intensive care unit, in which 159 infants had gastric intubation using ultrasound examination and radiological imaging, to verify positioning. Results were analyzed in terms of diagnostic accuracy.

Results: The tubes were correctly positioned in 157 cases (98.7%), according to radiological images, and in 156 cases (98.1%), according to ultrasound. The sensitivity analysis was 0.98 and the positive predictive value was 0.99. It was not possible to perform a specificity analysis, as there were not enough negative cases in the sample.

Implications for practice: The use of ultrasonography to identify correct positioning of gastric tubes in infants and newborns shows good sensitivity.

Implications for research: It was not possible to evaluate the ultrasonography specificity; further studies with greater samples are probably necessary, so that this objective can be achieved.Video Abstract available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=29&autoPlay=true.

Publication types

  • Observational Study
  • Video-Audio Media

MeSH terms

  • Enteral Nutrition
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Intubation, Gastrointestinal / methods*
  • Male
  • Radiography*
  • Stomach / diagnostic imaging*
  • Ultrasonography*