A Weight-Based Formula for the Estimation of Gastric Tube Insertion Length in Newborns

Freeman, Danielle; Saxton, Virginia; Holberton, James

doi:10.1097/anc.0b013e318256bb13

Cited by 31 publications

(38 citation statements)

References 10 publications

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“…74 Research specifically focused on neonates is needed to develop and validate insertion strategies such as previously published weight and height based formulas to improve the accuracy rate of feeding tube placement. 75,76 …”

Section: Discussion and Recommendationsmentioning

confidence: 99%

Aspiration and Evaluation of Gastric Residuals in the Neonatal Intensive Care Unit

Parker

Torrazza

et al. 2015

Journal of Perinatal &Amp; Neonatal Nursing

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The routine aspiration of gastric residuals (GR) is considered standard care for critically ill infants in the neonatal intensive care unit (NICU). Unfortunately, scant information exists regarding the risks and benefits associated with this common procedure. This article provides the state of the science regarding what is known about the routine aspiration and evaluation of GRs in the NICU focusing on the following issues: (1) The use of GRs for verification of feeding tube placement, (2) GRs as an indicator of gastric contents, (3) GRs as an indicator of feeding intolerance or necrotizing enterocolitis, (4) the association between GR volume and ventilator associated pneumonia, (5) whether GRs should be discarded or re-fed, (6) the definition of an abnormal GR, and (7) the potential risks associated with aspiration and evaluation of GRs. Recommendations for further research and practice guidelines are also provided.

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Section: Discussion and Recommendationsmentioning

confidence: 99%

Aspiration and Evaluation of Gastric Residuals in the Neonatal Intensive Care Unit

Parker

Torrazza

et al. 2015

Journal of Perinatal &Amp; Neonatal Nursing

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“…Currently, only one method, x-ray study, provides 100% accuracy in determining enteral tube tip location 4,11,14,18,22 and is considered the criterion standard by which to compare other verification methods. 31,35 A variety of other methods have been studied, but none afford the conclusive findings that an x-ray study provides.…”

Section: Tube Placement Verification Methodsmentioning

confidence: 99%

“…This method requires potentially time-consuming and error-prone mathematical calculations and, although successful in adults and children, has been minimally studied only in the neonatal population. 5,12 Minimal insertion length has been studied as a means to ensure gastric tube placement in infants weighing less than 1500 g. 19 In addition, Freeman and colleagues 18 proposed a weight-based formula for estimating enteral tube insertion length in infants. These methods may be useful in improving the accuracy of tube placement, especially when combined together with other methods.…”

Section: Placement Of Tubesmentioning

confidence: 99%

Following the Evidence

Clifford

Heimall

Brittingham

et al. 2015

Journal of Perinatal &Amp; Neonatal Nursing

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Enteral tube placement in hospitalized neonates and young children is a common occurrence. Accurate placement and verification are imperative for patient safety. However, despite many years of research that provides evidence for a select few methods and clearly discredits the safety of others, significant variation in clinical practice is still common. Universal adoption and implementation of evidence-based practices for enteral tube placement and verification are necessary to ensure consistency and safety of all patients. This integrative review synthesizes current and seminal literature regarding the most accurate enteral tube placement and verification methods and proposes clinical practice recommendations.

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“…It was found that 74% of the tubes were correctly positioned. (18) The assertiveness index using the NEX method (modified technique used in this study) by disregarding the tube orifices ranged from 68.3% to 71.7% according to analysis by position and 95% in the analysis by vertebrae. The error found resembles that described in the literature, with rates ranging from 5.0% to 31.7% of tubes in malposition, according to the analysis by vertebrae and positions, respectively.…”

Section: Discussionmentioning

confidence: 99%

Posicionamento de sonda enteral em neonatos segundo técnica modificada de mensuração

et al. 2017

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Objective: To evaluate the effectiveness of the enteral tube measurement using the modified nose -ear -xiphoid (NEX) technique by disregarding the tube distal orifices for placement in newborns' neonatal gastric cavity. Methods: A prospective study conducted in a neonatal unit of a teaching hospital in the city of São Paulo, based on the radiographic analysis of 60 radiographs of 28 newborns using enteral tubes measured by the modified technique, and who had thoracoabdominal radiography. Results: The correct placement index according to analysis by position was 68.3% and 71.7%, according to evaluators 1 and 2, respectively. In the analysis by vertebrae, 95% of tubes were properly placed in the gastric cavity. There was a statistically significant association between height and location of the enteral tube according to evaluator 2. Conclusion: The evaluated measurement technique presents a risk for inadequate enteral tube placement in newborns, and its application in clinical practice should not be encouraged. ResumoObjetivo: Avaliar a efetividade da mensuração de sonda enteral pela técnica modificada, nariz -orelha -apêndice xifoide, com desconto dos orifícios distais da sonda, para posicionamento na câmara gástrica de neonatos. Métodos: Estudo prospectivo, desenvolvido em unidade neonatal de um hospital de ensino do município de São Paulo, a partir da análise radiográfica de 60 radiografias de 28 neonatos em uso de sonda enteral mensurada pela técnica modificada, submetidos à radiografia toracoabdominal. Resultados: O índice de posicionamento correto, de acordo com a análise por posições, foi de 68,3% e 71,7%, segundo os avaliadores 1 e 2, respectivamente, enquanto na análise por vértebras, 95% das sondas estavam adequadamente locadas na câmara gástrica. Ocorreu associação estatisticamente significante entre estatura e localização da sonda enteral, segundo o avaliador 2. Conclusão: A técnica de mensuração avaliada apresenta risco para posicionamento inadequado da sonda enteral utilizada em neonatos, devendo ser desencorajada sua aplicação na prática clínica.

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A Weight-Based Formula for the Estimation of Gastric Tube Insertion Length in Newborns

Abstract: We propose a novel weight-based formula for estimation of gastric tube insertion length in newborn infants to improve the accuracy of this routine procedure.

Cited by 31 publications

References 10 publications

Aspiration and Evaluation of Gastric Residuals in the Neonatal Intensive Care Unit

Aspiration and Evaluation of Gastric Residuals in the Neonatal Intensive Care Unit

Following the Evidence

Posicionamento de sonda enteral em neonatos segundo técnica modificada de mensuração

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