Comparision of ultrasonography with direct radiographyand aspiration for the confirmation of nasogastric tubeplacement among intubated patients in the emergencyservise: A prospective,single-blind,cross-sectional study

Abstract

Aim: The position of the nasogastric tube should be confirmed after its initial insertion and prior to repeated use. The present studymakes a prospective comparison of the efficacy of ultrasonography, aspiration and direct radiography in confirming nasogastrictube placement among intubated patients. Materials and Methods: This prospective, single-blind and cross-sectional study included 45 (16 female and 29 male) patientsover the age of 18 who were intubated and had a nasogastric tube inserted at the Emergency Service between 01.03.2017 and30.08.2017. For the confirmation of NGT placement, both gastric aspiration and gastric auscultation were performed by the primaryphysician who initially inserted the NGT. The abdominal USG was performed by an emergency physician who had performed theprocedure 20 times previously.Results: The ultrasound had a sensitivity of 92%, a specificity of 100%, a positive predictive value of 100% and a negative predictivevalue of 50%. The direct radiography had a sensitivity of 57%, a specificity of 100%, a positive predictive value of 100% and a negativepredictive value of 14%. The aspiration method, in turn, had a sensitivity of 78.57%, a specificity of 66.67%, a positive predictive valueof 97.06% and a negative predictive value of 18.18% as a means of NGT placement confirmation. Conclusion: Bedside ultrasonography is more effective than the aspiration method and direct radiography for the placementconfirmation of NGT inserted into intubated patients in the emergency service.