Objectives: Confirmation of nasogastric tube (NGT) placement is sometimes difficult in clinical practice, especially in intubated, mechanically ventilated patients. The purpose of this study was to validate the accuracy of a manometric technique on confirmation of intragastric NGT placement in intubated, mechanically ventilated patients.
Methods: A total of 100 adult patients who underwent elective open abdominal surgery and required NGT placement were enrolled in this prospective descriptive study. After patients were anesthetized and intubated, an NGT was inserted to reach a predetermined depth according to the nose-earxiphoid method. The NGT position was verified by two blinded investigators: one using the manometric technique and the other using fiberscopic examination. The manometric technique involved using a cuff pressure manometer to verify NGT placement. The primary measurements, sensitivity and specificity of the manometric technique for verifying NGT placement, were calculated according to the standard findings of fiberscopic examination.
Results: In 81 of 100 NGT placements, intragastric placement was interpreted by the manometric technique. All of these 81 placements were confirmed by fiberscopic examination. The manometric technique was therefore 100 other 19 placements interpreted as extragastric placement by the manometric technique were confirmed by fiberscopic examination as being either in the oral cavity, trachea, or esophagus, indicating 100% specificity. These results revealed a 100% accuracy of the manometric technique in verifying intragastric NGT placement.
Conclusion: The manometric technique may be used to verify correct NGT placement for the purpose of gastric decompression and in those environments where a roentgenogram is not available.