Although radiologic confirmation of tube placement remains the "gold standard," there is growing evidence that pH testing of feeding-tube aspirates can reduce (although not totally eliminate) reliance on x-rays used for this purpose. This article describes that evidence and tells how it was obtained. Reducing the number of x-rays needed to confirm tube position can have far-reaching financial benefits.
Get full access to this article
View all access options for this article.
References
1.
Aronchik J., Epstein D., Gefter W., et al. Pneumothorax as a complication of placement of a nasoenteric tube. JAMA1984;252:3287-8.
2.
Balogh G., Adler S., VanderWoude J., et al. Pneumothorax as a complication of feeding tube placement. Am J Radiol1983;141:1275-7.
3.
Chang J., Melnick B., Bedger R., et al. Inadvertent endobronchial intubation with nasogastric tube. Arch Otolaryngol1982;108:528-9.
4.
Dorsey J., Cogordan J.Nasotracheal intubation and pulmonary parenchymal perforation. Chest1985;87:131-2.
5.
Grossman T., Duncavage J., Kay J., et al. Complications associated with a narrow-bore nasogastric tube . Ann Otol Rhinol Laryngol1984;93:460-3.
6.
Hand R., Kempster M., Levy J., et al. Inadvertent transbronchial insertion of narrow-bore feeding tubes. JAMA1984;251:2396-7.
7.
Hendry P., Akyurekli Y., McIntryre, et al. Bronchopleural complications of nasogastric feeding tubes. Crit Care Med1986;14:892-4.
8.
Kiwak M., McLoud T., Dedrick C., et al. Entriflex feeding tube: need for care in using it. Am J Radiol1984;143:1341-2.
9.
Lipman T., Kessler T., Arabian A.Nasopulmonary intubation with feeding tubes: case reports and review of the literature. JPEN1985;9:618-20.
10.
McDanal J., Wheeler D., Ebert J.A complication of nasogastric intubation: pulmonary hemorrhage. Anesthesiology1983;59:356-8.
11.
Metheny N., Dettenmeier P., Hampton K., et al. Detection of inadvertent respiratory placement of small-bore feeding tubes: a report of 10 cases. Heart Lung1990;19:631-8.
12.
Miller K., Tomlison J., Sahn S.Pleuropulmonary complications of enteral tube feeding. Chest1985;88:230-3.
13.
Muthuswamy P., Patel K., Rajemdran R.Isocal pneumonia with respiratory failure . Chest1982;81:390.
14.
Olbrantz K. , Gelfand D., Choplin , et al. Pneumothorax complicating enteral feeding tube placement. JPEN1985;9:210-1.
15.
Roubenoff R. , Ravich W.Pneumothorax due to nasogastric feeding tubes . Arch Intern Med1989;149:184-8.
16.
Saltzbert D. , Goldstein M., Levine G.Feeding tube induced pneumothorax. JPEN1984;8:714-5.
17.
Schlorlemmer G., Battaglini J.An unusual complication of nasoenteral feeding with small-diameter feeding tubes. Ann Surg1984;199:104-6.
18.
Sweatman A. , Tomasello P., Loughhead M., et al. Misplacement of nasogastric tubes and oesophageal monitoring devices. Br J Anaesth1978;50:389-92.
19.
Theodore A. , Frank J., Ende J., et al. Errant placement of nasoenteric feeding tubes: a hazard in obtunded patients. Chest1984;86:931-3.
20.
Torrington K., Bowman M.Fatal hydrothorax empyema complicating a malpositioned nasogastric tube. Chest1981 ;79:240-2.
21.
Valentine R. , Turner W.Pleural complications of nasoenteric feeding tubes. JPEN1985;9:605-7.
22.
Metheny N., Spies M., Eisenberg P.Frequency of nasoenteral tube displacement and associated risk factors . Res Nurs Health1986;9:241-7.
23.
Eisenberg P. , Spies M., Metheny N.Characteristics of patients who remove their nasal feeding tubes. Clin Nurse Spec1987;1:94-8.
24.
Metheny N., McSweeney M., Wehrle M., et al. Effectiveness of the auscultatory method in predicting feeding tube location. Nurs Res1990;39:262-7.
25.
Metheny N., Reed L., Wiersema L., et al. Effectiveness of pH measurements in predicting feeding tube placement: an update. Nurs Res1993;42:324-31.
26.
Metheny N., Reed L., Clark J., et al. How to aspirate fluid from small-bore feeding tubes. Am J Nurs1993;93:86-8.
27.
Sahn S.State of the art: the pleura. Am Rev Respir Dis1988;138:184-234.
28.
Griggs B., Hoppe M.Nasogastric tube feeding. Am J Nurs1979;79:481-5.
29.
Metheny N., Williams P., Wiersema L., et al. Effectiveness of pH measurements in predicting feeding tube placement. Nurs Res1989;38:280-5.
30.
Metheny N.Minimizing respiratory complications of nasoenteric tube feedings: state of the science. Heart Lung1993;22:213-23.
31.
Potts R., Zaroukian M., Guerrero P., et al. Comparison of blue dye visualization and glucose oxidase test strip methods for detecting pulmonary aspiration of enteral feedings in intubated adults. Chest1993;103:117-21.
32.
Metheny N., Reed L., Berglund B., et al. Use of visual characteristics of aspirates from feeding tubes as a method for predicting tube location. Nurs Res1994;43:282-7.
