Prediction of nasogastric tube position in neonates admitted on a NICU; a comparison of two methods

Aim

To describe the number of appropriate orogastric/nasogastric (OG/NG) tube positions according to the age-related-height-based (ARHB) measurement compared with the used nose-ear-midway to the umbilicus method (NEMU) aiming for a decrease in tubes placed too deeply and no significance in tubes placed too highly.

Methods

A prospective observational multi-centre study was conducted in three level III NICU's. All neonates requiring OG/NG tube were eligible. NEMU was used to determine the insertion length for OG/NG tubes. The position according to the ARHB was calculated using equations appropriate for the tube type. Radiological assessment was used to objectify the position of the tubes.

Results

In 475 neonates the position of the OG/NG was radiologically visible. The percentage of correctly placed tubes using ARHB compared with NEMU was 44% vs 33.9% (p = 0.001). A decrease in the number of tubes inserted too deeply according to ARHB was observed 24.6% vs 49.1% with NEMU (p < 0.001). A significant increase in too highly placed tubes was observed with ARHB compared to NEMU 31.4% vs 17% (p < 0.001).

Conclusion

The increase in too highly placed tubes, according to ARHB was undesirable. The method used for calculating the insertion length of the OG/NG tubes in neonates remains unclear.