Following the Evidence

Clifford, Patricia; Heimall, Lauren; Brittingham, Lori; Davis, Katherine Finn

doi:10.1097/jpn.0000000000000104

Cited by 18 publications

(13 citation statements)

References 25 publications

(42 reference statements)

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“…Relacionado aos cateteres nasogástricos houve convergência para as técnicas já citadas: NEX, ENX e NEMU, respectivamente. Este cenário torna imprescindível o incentivo para realização de estudos sobre a colocação de tubos gástricos para nutrição enteral em neonatologia, pois estes são objetos de diversas investigações nas clientelas pediátrica e adulta, e, ainda assim, são permeadas por controvérsias relacionadas ao procedimento 7,8 .…”

Section: Resultsunclassified

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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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Section: Resultsunclassified

“…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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“…In the description of an implementation protocol for tube maintenance in NBs 5 and in an integrative review 38 , the authors recommend that the external length should be checked and recorded in the medical record and/or recorded on the tube in a visible manner, always confirming it before use. However, it is relevant to consider that keeping the external length stable does not eliminate the risk of internal displacement.…”

Section: Discussionmentioning

confidence: 99%

“…However, literature indicates that it is possible to listen to the air bubbles in the epigastric region, regardless of whether the end of the tube is located in the stomach, esophagus or respiratory tract. Therefore, the use of this technique is discouraged and should be banned 1 , 16 , 29 - 32 , 38 .…”

Section: Discussionmentioning

confidence: 99%

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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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Randomized Clinical Trial Comparing Two Methods of Measuring Insertion Length of Nasogastric Tubes in Newborns

Dias

Jales

Álvares

et al. 2020

J Parenter Enteral Nutr

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IntroductionThe selection of a method for measuring the insertion length of nasogastric tubes in newborns is an important factor in establishing the safe use of this device.ObjectiveThe objective was to verify whether there is a difference in the proportion of correctly placed nasogastric tubes when using the nose, earlobe, mid‐umbilicus (NEMU) method and the weight‐based equation for measuring the insertion length.MethodsThis study is a randomized, controlled, blinded study comparing 2 methods of nasogastric insertion at a neonatal unit, with intensive and intermediate care, on 162 randomized individuals. Radiological assessment and pH test were conducted to verify tube placement. Data were collected on sex, birth weight, gestational age, and days of life. A log‐binomial model was used to verify whether there were placement differences between investigated methods.ResultsOf the patients, 56.1% were male, who had a mean birth weight of 1886.8 g and gestational age of 32.9 weeks and were 10.8 days old. Radiological images demonstrated that tubes were properly placed in the gastric body in 67.5% of patients using the NEMU method and in 91.5% using the weight‐based equation: the weight‐based equation was superior to the NEMU method, with a prevalence ratio of 1.36 (95% CI, 1.15–1.44). There was no difference between the 2 methods, according to pH test (P‐value: .7179).ConclusionBased on radiographic confirmation, the weight‐based equation for measuring the insertion length of the nasogastric tube in newborns resulted in significantly more nasogastric tubes being placed in the correct intragastric location.

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Following the Evidence

Cited by 18 publications

References 25 publications

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

Randomized Clinical Trial Comparing Two Methods of Measuring Insertion Length of Nasogastric Tubes in Newborns

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