2-Point Ultrasonography to Confirm Correct Position of the Gastric Tube in Prehospital Setting

Abstract

The 2-point ultrasonographic live control of the GT position has a better sensitivity and a much higher specificity than the syringe test but similar to the xiphoid ultrasound control. However, our method allows to show the GT in the esophagus and to use the dynamic ultrasound fogging to reveal an intragastric position that was not obvious with the common techniques.

The evaluation of efficacy of three different ultrasonography methods for verification of gastric tube placement in intensive care unit patients

“…Mean confirmation time of GT position was 18 seconds [15]. In our study, we also found similar results those found in the study by Brun et al (2014). In our study, gastric USG failed to confirm the accurate position of GT in seven patients due to full stomach and gas intervention.…”

“…In a study performed in 132 patients by Brun et al (2014), the position of GT was confirmed in esophagus in 100% of all patients and in stomach in 62.5% through USG. Mean confirmation time of GT position was 18 seconds [15]. In our study, we also found similar results those found in the study by Brun et al (2014).…”

“…For the first time, the sonography was used by Hernandez-Socorro et al (2013) to confirm the accurate position of a naso-enteric feeding tube during the passage of pylorus [22]. In studies performed in later period, the success rates related to the monitoring of tubes via gastric USG are controversial [15,17]. Lock et al (2003) confirmed the placement of GT with the insufflation of 50 mL air in 55 patients hospitalized in ICU.…”

“…However, radiography is associated with undesirable factors, such as exposure to ionizing radiation, cost and time-consuming [9,10]. In recent years, increasing number of studies have examined the efficacy of USG as an alternative to radiography for confirming the position of GT [11][12][13][14][15][16][17]. However, there are controversial and conflicting results on diagnostic accuracy, and there is no consensus on the role of USG in routine clinical practice.…”

“…In addition, direct visualization of stomach as a definitive verification method can be difficult due to interposition, gastric content and patients' characteristics (obese or excessively mobile) [11][12][13][14]. Therefore, additional methods, such as combining different scanning points and visualization of dynamic fogging or Doppler signal due to air insufflation can be used to improve the accuracy of diagnosis [15][16][17][18]. In our previous study, we revealed that passing of GT through the esophagus could be visualized at a higher rate in real time with USG [19].…”