Accuracy of colour Doppler ultrasound for nasogastric tube placement in emergency department: A prospective observational study

IF 1.7 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia Pub Date : 2025-03-04 DOI:10.1111/1742-6723.70020

Ming Yee Ong MMed Emergency, Ahmad Zulkarnain Ahmad Zahedi MMed Emergency, Aliyah Zambri MMed Emergency, Muhaimin Noor Azhar MMed Emergency, Aida Bustam MMed Emergency, Rabiha Mohd Alip MMed Emergency, Mohammad Fadhly Yahya MMed Emergency, Khadijah Poh MMed Emergency

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引用次数: 0

Abstract

Objective

Nasogastric tube (NGT) placement is a common procedure in EDs. Successful NGT placement reduces complications such as aspiration pneumonia, pneumothorax and mortality. While chest radiography is the gold standard for confirmation, colour Doppler ultrasonography (CDU) has demonstrated high accuracy. As its applicability in the ED remains underexplored, the present study evaluates the accuracy of CDU in confirming NGT placement in the ED.

Methods

A prospective observational study was conducted in a tertiary hospital ED from October 2022 to October 2023. Adult patients requiring NGT insertion were eligible. NGT placement was performed using a standardised protocol and confirmed with CDU and chest radiography. Accuracy of CDU was assessed against chest radiography, and procedural times for confirmation were compared using the Kruskal–Wallis H test.

Results

Of 157 patients screened, 144 were included. CDU demonstrated 92.45% (95% confidence interval 85.67–96.69) sensitivity, 80.56% (63.98–91.81) specificity, positive predictive value 0.93 (0.88–0.96), negative predictive value 0.78 (0.64–0.88), positive likelihood ratio 4.75 (2.44–9.27) and negative likelihood ratio 0.09 (0.05–0.19). The median (interquartile range) confirmation times were 3.0 min (2.0–3.0) for CDU and 42.0 min (30.0–55.0) for radiography (P < 0.001).

Conclusion

CDU should not currently be used as a standalone method for confirming NGT placement due to its limitations and risk of false-positive results. Further research is required to address these challenges before considering its clinical implementation.

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来源期刊

Emergency Medicine Australasia 医学-急救医学

CiteScore

3.70

自引率

13.00%

发文量

217

审稿时长

6-12 weeks

期刊介绍： Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.