Malposition of Feeding Tubes in Neonates: Is It an Issue?

Quandt, Daniel; Schraner, Thomas; Bucher, Hans Ulrich; Mieth, Romaine Arlettaz

doi:10.1097/mpg.0b013e31818c52a8

Cited by 51 publications

(49 citation statements)

References 18 publications

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“…Feeding tube positions on radiographs were then assessed and compared with a control group (n=381 radiographs of 173 neonates) having no injection of air. A minimal sample size of 148 for each group was calculated on the hypothesis that the rate of 21% of ‘undefinable’ feeding tube positions from a previous study2 could be reduced by 50% (one-sided α 0.05, β 0.2).…”

Section: Methodsmentioning

confidence: 99%

“…Radiographs, though not routinely performed to check tube placement, are actually considered to be the gold standard 1. In a previous study, we analysed 381 radiographs retrospectively 2. We found that in one-fifth of the radiographs, no exact statement regarding tube position was possible, because the gas bubble of the stomach was not always visible and radiographs in neonatal intensive care units are usually performed only in an anterior–posterior plane.…”

Section: Introductionmentioning

confidence: 99%

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Improved radiological assessment of neonatal feeding tubes

Quandt

Brøns

Schiffer

et al. 2012

Arch Dis Child Fetal Neonatal Ed

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improved radiological assessment of neonatal feeding tubes

Quandt

Brøns

Schiffer

et al. 2012

Arch Dis Child Fetal Neonatal Ed

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“…In a retrospective investigation, Quandt and colleagues 8 reported that NG-EAD misplacement occurred in 59% of the 381 radiographs reviewed from 173 neonates. Although single-center reporting is useful, the overall number of NG-EADs placed and used in US facilities specifically in children and the overall incidence of misplacement or dislodgement are unknown.…”

Section: Misplacement and Dislodgementmentioning

confidence: 99%

“…[5][6][7][8] Halloran et al 9 estimated that more than 1 million NG-EADs are placed annually in adults. However, the number of NG-EADs placed and used in children and the frequency of placement errors is not known.…”

Section: Introductionmentioning

confidence: 99%

Nasogastric Tube Placement and Verification in Children: Review of the Current Literature

Irving¹,

Lyman

Northington

et al. 2014

Critical Care Nurse

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Placement of a nasogastric enteral access device (NG-EAD), often referred to as a nasogastric tube, is common practice and largely in the domain of nursing care. Most often an NG-EAD is placed at the bedside without radiographic assistance. Correct initial placement and ongoing location verification are the primary challenges surrounding NG-EAD use and have implications for patient safety. Although considered an innocuous procedure, placement of an NG-EAD carries risk of serious and potentially lethal complications. Despite acknowledgment that an abdominal radiograph is the gold standard, other methods of verifying placement location are widely used and have success rates from 80% to 85%. The long-standing challenges surrounding bedside placement of NG-EADs and a practice alert issued by the Child Health Patient Safety Organization on this issue were the stimuli for the conception of The New Opportunities for Verification of Enteral Tube Location Project sponsored by the American Society for Parenteral and Enteral Nutrition. Its mission is to identify and promote best practices with the potential of technology development that will enable accurate determination of NG-EAD placement for both the inpatient and outpatient pediatric populations. This article presents the challenges of bedside NG-EAD placement and ongoing location verification in children through an overview of the current state of the science. It is important for all health care professionals to be knowledgeable about the current literature, to be vigilant for possible complications, and to avoid complacency with NG-EAD placement and ongoing verification of tube location.

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“…Depending on the definition of malposition, error rates range from 21% to 56%. [4][5][6][7] Errors in initial placement, and those related to displacements that occur over time, can lead to deleterious consequences and result in serious patient harm. Enteral tubes located in the esophagus, or placed inadvertently in the lungs, can lead to apnea, bradycardia, desaturations, and aspiration.…”

mentioning

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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Malposition of Feeding Tubes in Neonates: Is It an Issue?

Abstract: There is a need for both better rules to measure the distance between nose (lips) and the body of the stomach and improved methods to confirm correct tube position in neonates.

Cited by 51 publications

References 18 publications

Improved radiological assessment of neonatal feeding tubes

Improved radiological assessment of neonatal feeding tubes

Nasogastric Tube Placement and Verification in Children: Review of the Current Literature

Following the Evidence

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