Nguyen Sarah, Fang Alice, Saxton Virginia, Holberton James
Department of Paediatrics (Drs Nguyen and Holberton) and Medical Imaging (Dr Saxton), Mercy Hospital for Women, Heidelberg; and Department of Paediatrics (Dr Fang), Box Hill Hospital, Box Hill, Victoria, Australia.
Adv Neonatal Care. 2016 Apr;16(2):158-61. doi: 10.1097/ANC.0000000000000261.
Gastric tubes are used in nurseries on a daily basis. Various methods of estimating gastric tube length for insertion using anatomical landmarks are used to assist correct placement. Sometimes, however, they can be up to 55% inaccurate. In 2012, we published a weight-based formula to estimate gastric tube length for insertion.
This study reviews the rates of correct gastric tube placement, as confirmed by radiography, after the incorporation of this weight-based formula into bedside practice.
A 6-month prospective study was performed in a tertiary neonatal intensive care unit. The formula estimating gastric tube length for insertion had been derived in an earlier study. This was incorporated into the hospital's policies and procedures guideline for the insertion of gastric tubes. Neonates with gastric tubes who required radiography for clinical reasons were included. The infant's weight and the type (orogastric or nasogastric) and length of tube were documented. A single radiologist assessed the tube position to be high, borderline, correct, or long.
A total of 195 chest radiographs were obtained. Correct tube position was found in 84% of instances. This was a statistically and clinically significant improvement.
Implementation of a simple weight-based estimate for gastric tube length improves correct position rates.
Further studies comparing accuracy of length/height and weight-based estimations for gastric tube insertion lengths in very preterm and extremely preterm infants are needed.
胃管在新生儿重症监护室中每天都会使用。临床上使用各种基于解剖标志来估计胃管插入长度的方法，以辅助正确放置胃管。然而，有时这些方法的误差高达55%。2012年，我们发表了一种基于体重的公式来估计胃管插入长度。
本研究旨在探讨将这种基于体重的公式应用于临床实践后，经X线检查确认的胃管正确放置率。
在一家三级新生儿重症监护病房进行了一项为期6个月的前瞻性研究。估计胃管插入长度的公式是在早期研究中得出的。该公式已纳入医院胃管插入的政策和程序指南中。纳入因临床原因需要进行X线检查的胃管置入新生儿。记录婴儿的体重、胃管类型（口胃管或鼻胃管）和长度。由一名放射科医生评估胃管位置是过高、临界、正确还是过长。
共获得195份胸部X线片。84%的病例胃管位置正确。这在统计学和临床上都有显著改善。
实施简单的基于体重的胃管长度估计方法可提高正确放置率。
需要进一步研究比较基于身长/身高和体重的胃管插入长度估计方法在极早产儿和超早产儿中的准确性。
