Confirming nasogastric tube position: Methods and restrictions: A narrative review

Abstract

Background and Purpose: Inserting a nasogastric tube, though a common clinical procedure with widespread use for critically illpatients, can produce unexpected complications so that tube misplacement into the lungs is a potential complication with seriousconsequences. The reliability of common bedside methods to differentiate between pulmonary and gastric placement has not beenacceptable. The goal of this study was to review the diagnostic accuracy of methods in detecting inadvertent airway intubation andverifying correct placement of nasogastric tube and restrictions.Methods: A review of Pub Med, Medline and CINAHL databases has been conducted to identify peer-reviewed, English language,human subject research studies published between the years 1994 and 2013.The research was conducted on the confirmation,methods and restrictions of NGT in the adult's population. Out off 151 English publications, 29 were duplicates and 2 were animalstudies. Quality assessments, data extractions and analysis were completed on all included studies.Results: Although methods for assessing correct NGT location at the bedside are available, each has its limitations. Themethods include auscultation (the most common method), PH testing of aspirates, capnography, insertion under directvision and magnetic detection. All studies used X-rays as the reference standard for comparison since auscultation isunreliable.Conclusion: While none of the existing bedside methods for testing the position of nasogastric tubes