Accuracy of a Weight-Based Formula for Neonatal Gastric Tube Insertion Length

Nguyen, Sarah; Fang, Alice; Saxton, Virginia; Holberton, James

doi:10.1097/anc.0000000000000261

Cited by 18 publications

(26 citation statements)

References 11 publications

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“…The use of the weight-based formula as an auxiliary method to NEMU in GT insertion was described in another study 27 , however, the result was lower than expected, with 16% of tubes being incorrectly positioned (above or near the gastroesophageal junction). The authors suggest that this result is justified by the fact that the formula was not fully incorporated by the nursing team as a measurement strategy.…”

Section: Resultsmentioning

confidence: 94%

“…Among the articles that addressed GT measurement, four were observational studies 13 , 18 , 22 , 27 and two were experimental studies 12 , 20 , and were mostly published in nursing journals. With regard to ethical aspects, only one article 12 did not report having submitted the study to ethical appreciation.…”

Section: Resultsmentioning

confidence: 99%

“…Equations that use height 18 , 20 and weight 22 , 27 to calculate the gastric tube insertion measure seem to reproduce reliable results; however, the absence of experimental studies with such methods impedes them being used as a single reference. Therefore, it is suggested that these equations are only used as a supporting measure in the decision on the tube length to be introduced, at least until studies with new evidence are available.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Procedures for measuring and verifying gastric tube placement in newborns: an integrative review

Dias

Emídio

Lopes

et al. 2017

Rev. Latino-Am. Enfermagem

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Objective:to investigate evidence in the literature on procedures for measuring gastric tube insertion in newborns and verifying its placement, using alternative procedures to radiological examination. Method:an integrative review of the literature carried out in the Cochrane, LILACS, CINAHL, EMBASE, MEDLINE and Scopus databases using the descriptors “Intubation, gastrointestinal” and “newborns” in original articles. Results:seventeen publications were included and categorized as “measuring method” or “technique for verifying placement”. Regarding measuring methods, the measurements of two morphological distances and the application of two formulas, one based on weight and another based on height, were found. Regarding the techniques for assessing placement, the following were found: electromagnetic tracing, diaphragm electrical activity, CO2 detection, indigo carmine solution, epigastrium auscultation, gastric secretion aspiration, color inspection, and evaluation of pH, enzymes and bilirubin. Conclusion:the measuring method using nose to earlobe to a point midway between the xiphoid process and the umbilicus measurement presents the best evidence. Equations based on weight and height need to be experimentally tested. The return of secretion into the tube aspiration, color assessment and secretion pH are reliable indicators to identify gastric tube placement, and are the currently indicated techniques.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Procedures for measuring and verifying gastric tube placement in newborns: an integrative review

Dias

Emídio

Lopes

et al. 2017

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

show abstract

“…However, the result was lower than expected, with incorrect placement in 16% of tubes, i.e., above or near the gastroesophageal junction. The authors suggested this result is justified by the fact that the nursing team did not fully incorporate the formula as a strategy to check the measure- (17) Few studies report the measurement of the tip orifices of the tubes used, although this factor is important to ensure the administration of diet and medications in the gastric cavity. In studies where this value was reported, measurements ranged from 1.5 cm to 3.0 cm.…”

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 intubação gastrintestinal é um dos procedimentos mais frequentemente usados na prática assistencial da enfermagem por todo o mundo, sendo indicada para alimentação, descompressão, lavagem e aspiração gástrica, além da administração de medicamentos 5,[7][8][9][10][11] .…”

Section: Revisão De Literaturaunclassified

Cateterização gástrica em recém-nascidos prematuros: análise de prevalência das técnicas de mensuração [Gastric tube insertion in preterm infants: prevalence analysis of measurement techniques] [Cateterización gástrica en neonatos prematuros: análisis de prevalencia de las técnicas de medición]

et al. 2019

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Objetivo: identificar a prevalência das técnicas de mensuração para inserção de cateter gástrico em recém-nascidos prematuros utilizadas pela equipe de enfermagem da unidade de terapia intensiva neonatal. Método: trata-se de uma pesquisa de corte transversal, realizada entre maio e agosto de 2018, em um hospital universitário da cidade do Rio de Janeiro, que contou com a participação de 52 profissionais, e a coleta de dados foi efetuada através do autopreenchimento de questionários pelos participantes do estudo. Foi utilizada estatística descritiva para a análise de dados. O estudo passou por aprovação de Comitê de Ética em Pesquisa. Resultados: foram encontradas seis técnicas distintas, que variaram de acordo com a via de inserção, oral e nasal. Metade delas não foi descrita na literatura. Conclusão: as técnicas mais prevalentes foram CEX (comissura labial-orelha-xifoide), NEX (nariz-orelha-xifoide) e ENX (orelha-nariz-xifoide), no entanto nenhuma delas foi validada para neonatologia, devido à escassez de pesquisas voltadas para os recém-nascidos.ABSTRACTObjective: to identify the prevalence of measurement techniques used by the neonatal intensive care unit nursing team for gastric tube insertion in preterm newborns. Method: in this cross-sectional study, carried out between May and August 2018 at a university hospital in Rio de Janeiro City, the participants were 52 health professionals. Data were collected by self-completed questionnaire and analyzed using descriptive statistics. The study was approved by the research ethics committee. Results: six different techniques were found, which varied by route of insertion (oral or nasal). Half of these have not been described in the literature. Conclusion: the most prevalent techniques were CEX (labial commissure-earlobe-xiphoid), NEX (nose-earlobe-xiphoid) and ENX (earlobe-nose-xiphoid). However, none has been validated for neonatology due to the lack of research directed to newborns.RESUMENObjetivo: identificar la prevalencia de las técnicas de medición para inserción de catéter gástrico en neonatos prematuros utilizadas por el equipo de enfermería de la unidad de terapia intensiva neonatal. Método: se trata de una investigación de corte transversal, realizada entre mayo y agosto de 2018, en un hospital universitario de la ciudad de Río de Janeiro, que contó con la participación de 52 profesionales. La recolección de datos se efectuó a través del autollenado de cuestionarios por los participantes del estudio. Se utilizó estadística descriptiva para el análisis de datos. El estudio pasó por la aprobación del Comité de Ética en Investigación. Resultados: se encontraron seis técnicas distintas, que variaron de acuerdo con la vía de inserción, oral y nasal. La mitad de ellas no se encuentra en la literatura médica. Conclusión: las técnicas más prevalentes fueron CEX (comisura labial-oreja-xifoides), NEX (nariz-oreja-xifoides) y ENX (oreja-nariz-xifoides), sin embargo ninguna de ellas fue validada para neonatología, debido a la escasez de investigaciones volcadas hacia los neonatos.

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Accuracy of a Weight-Based Formula for Neonatal Gastric Tube Insertion Length

Abstract: Further studies comparing accuracy of length/height and weight-based estimations for gastric tube insertion lengths in very preterm and extremely preterm infants are needed.

Cited by 18 publications

References 11 publications

Procedures for measuring and verifying gastric tube placement in newborns: an integrative review

Procedures for measuring and verifying gastric tube placement in newborns: an integrative review

Posicionamento de sonda enteral em neonatos segundo técnica modificada de mensuração

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