de Boer Jacoba Coby, Smit Bert J, Mainous Rosalie O
Division of Neonatology, Erasmus MC, Sophia Children's Hospital, Department of Pediatrics, Division of Neonatology, Rotterdam, The Netherlands.
Adv Neonatal Care. 2009 Dec;9(6):293-8. doi: 10.1097/ANC.0b013e3181c1fc2f.
For neonates receiving intensive care, nasogastric tube feeding is essential. Since nasogastric tube placement techniques are not well standardized and common verification methods can be unreliable, placement errors may lead to unsafe situations. In mechanically ventilated neonates and neonates on continuous positive airway pressure, malpositioning of the nasogastric tube may prevent excess air within the stomach to escape. In this study, we aimed to relate tube position to amount of air. The hypothesis was: the better the position of the tube, the smaller the amount of air in the stomach.
A 1-year cohort of neonates in a level IIIc neonatal intensive care unit with a nasogastric tube.
We retrospectively reviewed 326 radiographs and classified nasogastric tube position and gastric air. Descriptive statistics were used to describe demographic data. Kendal's tau statistic was applied to explore the relationship between nasogastric tube position and amount of gastric air. A Mann-Whitney U test was performed to confirm the differences in gastric air in neonates with Ch5 and Ch6 gastric tubes and neonates with Ch8 gastric tubes.
One or both orifices of nasogastric tubes were in the esophagus in 7.1% of cases, tubes were curled up in the stomach in 35.3% of cases, and tube tips were beyond the pyloric sphincter in 5.5% of cases. Substantial or excessive air was found in 37.7% of cases. Kendal's tau value indicated that there was no significant correlation between nasogastric tube position and gastric air. The Mann-Whitney U value indicated that children with Ch5 and Ch6 gastric tubes had significantly more gastric air than children with Ch8 gastric tubes.
Nasogastric tubes were malpositioned in nearly half of cases, and substantial or excessive air was found in more than one-third of cases. The hypothesis-the better the position of the tube, the smaller the amount of gastric air-was not confirmed by the data. However, a significant relationship was found between tube size and gastric air.
对于接受重症监护的新生儿，鼻胃管喂养至关重要。由于鼻胃管置入技术尚未得到很好的标准化，且常用的验证方法可能不可靠，置入错误可能导致不安全情况。在机械通气的新生儿和持续气道正压通气的新生儿中，鼻胃管位置不当可能会阻止胃内多余空气排出。在本研究中，我们旨在将导管位置与空气量相关联。假设是：导管位置越好，胃内空气量越少。
一个三级c级新生儿重症监护病房中使用鼻胃管的1岁新生儿队列。
我们回顾性分析了326张X光片，并对鼻胃管位置和胃内空气进行分类。描述性统计用于描述人口统计学数据。使用肯德尔tau统计量来探讨鼻胃管位置与胃内空气量之间的关系。进行曼-惠特尼U检验以确认使用Ch5和Ch6胃管的新生儿与使用Ch8胃管的新生儿胃内空气的差异。
7.1%的病例中鼻胃管的一个或两个开口位于食管内，35.3%的病例中导管在胃内卷曲，5.5%的病例中导管尖端超出幽门括约肌。37.7%的病例中发现有大量或过多的空气。肯德尔tau值表明鼻胃管位置与胃内空气之间无显著相关性。曼-惠特尼U值表明使用Ch5和Ch6胃管的儿童胃内空气明显多于使用Ch8胃管的儿童。
近一半的病例中鼻胃管位置不当，超过三分之一的病例中发现有大量或过多的空气。数据未证实“导管位置越好，胃内空气量越少”这一假设。然而，发现导管尺寸与胃内空气之间存在显著关系。
