Comparison of 4 point-of-care techniques to detect correct positioning of nasogastric tubes in dogs (2020–2021)

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care Pub Date : 2023-08-10 DOI:10.1111/vec.13327

Meera Ramesh DVM, Aimee C Brooks DVM, MS, DACVECC, Elizabeth Thomovsky DVM, MS, DACVECC, Paula Johnson DVM, DACVECC, Carrie Fulkerson DVM, Nollie Parnell DACVIM, Hsin-Yi Weng BVM, MPH, PhD

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引用次数: 0

Abstract

Objective

To compare 4 point-of-care (POC) techniques to assess nasogastric (NG) tube placement versus radiographs as a reference standard. POC methods included air inflation with auscultation, fluid aspiration with pH measurement, ultrasonography, and capnography.

Design

Prospective observational study in hospitalized dogs between 2020 and 2021.

Setting

University teaching hospital.

Animals

Fifty-one dogs requiring NG tube placement as part of their normal care.

Interventions

After standard blind NG tube placement, each POC method was performed following standardized instructions. All POC methods were scored as to whether the investigator believed the tube to be in the gastrointestinal tract (as indicated by positive auscultation of borborygmus during insufflation, positive fluid aspiration with pH ≤5, presence of hyperechoic shadow in the esophagus, or absence of capnographic waveform). Subsequently, radiographs were taken to determine NG tube position as a gold standard. The sensitivity, specificity, and accuracy of each test as compared to 2-view thoracic radiographs were determined.

Measurements and Main Results

Sensitivity, specificity, and accuracy for each POC technique were as follows: air auscultation (84.4%, 50.5%, and 80.4%, respectively), neck ultrasound (95.6%, 83.3%, and 94.1%, respectively), capnography (91.1%, 33.3%, and 84.3%, respectively), and fluid aspiration with pH measurement (22.2%, 100%, and 31.4%, respectively).

Conclusions

Among the 4 techniques evaluated, neck ultrasound had the best overall performance for assessing NG tube placement. Fluid aspiration with pH measurement might also have potential due to perfect specificity, but its clinical utility may be limited by low sensitivity and accuracy. Nonetheless, 2-view thoracic radiography should still be considered the standard method for confirmation of NG tube placement as none of the 4 POC techniques investigated showed both high sensitivity and perfect specificity.

查看原文本刊更多论文

4种护理点技术检测犬鼻胃导管正确定位的比较（2020-2021）。

目的：比较作为参考标准的4点护理（POC）技术评估鼻胃（NG）管放置与射线照片。POC方法包括听诊充气、pH测量液体抽吸、超声检查和脑电图检查。设计：2020年至2021年间对住院狗进行的前瞻性观察性研究。背景：大学教学医院。动物：51只狗需要放置NG管作为其正常护理的一部分。干预措施：在标准盲NG管放置后，按照标准说明进行每种POC方法。对所有POC方法进行评分，以确定研究者是否认为导管在胃肠道中（如吹入过程中的波眼听诊阳性、pH≤5的液体抽吸阳性、食道中存在高回声阴影或无心电图波形）。随后，拍摄射线照片以确定NG管的位置，作为金标准。与2视图胸部x线片相比，确定了每项测试的敏感性、特异性和准确性。测量和主要结果：每种POC技术的敏感性、特异性和准确性如下：空气听诊（分别为84.4%、50.5%和80.4%）、颈部超声（分别为95.6%、83.3%和94.1%）、二氧化碳描记术（分别为91.1%、33.3%和84.3%）和pH测量液体抽吸（分别为22.2%、100%和31.4%）。结论：在评估的4种技术中，颈部超声在评估NG管放置方面具有最佳的整体性能。由于具有完美的特异性，pH测量的液体抽吸也可能具有潜力，但其临床应用可能因灵敏度和准确性低而受到限制。尽管如此，2视野胸部放射线照相术仍应被视为确认NG管放置的标准方法，因为所研究的4种POC技术均未显示出高灵敏度和完美的特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of veterinary emergency and critical care 农林科学-兽医学

CiteScore

2.50

自引率

15.40%

发文量

121

审稿时长

18-36 weeks

期刊介绍： The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.