Rigobello Mayara Carvalho Godinho, Herrera Claire Nierva, Bonacim Carlos Alberto Grespan, Pereira Rosana Aparecida, Nunes Roosevelt Santos, Junior Jorge Elias, Gimenes Fernanda Raphael Escobar
Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Ribeirão Preto College of Nursing, University of São Paulo, Avenida dos Bandeirantes, 3900, Campus Universitário, Bairro Monte Alegre, Ribeirão Preto, São Paulo, Brazil.
J Ultrasound. 2025 Mar;28(1):53-61. doi: 10.1007/s40477-024-00960-2. Epub 2024 Oct 15.
To analyze the accuracy and costs of bedside methods for confirming the position of a nasoenteral feeding tube newly inserted blindly by nurses.
Diagnostic accuracy study of three clinical methods (ultrasound, epigastric auscultation, and pH measurement) compared to radiography. The direct costs of each method used to confirm the positioning of the nasoenteral tube were also measured.
Seventy-six adult patients underwent a total of 87 nasoenteral tube insertion procedures in hospital units located within the Northeast region of the State of São Paulo, Brazil. The clinical methods were conducted on all study participants in the specified sequence: ultrasound (as index test), followed by epigastric auscultation and pH measurement (also index tests).
The outcomes regarding the confirmation of the accurate positioning of the nasoenteral tube are as follows: ultrasonography demonstrated sensitivity and specific of 79.0% and 66.7%, respectively. Epigastric auscultation exhibited a sensitivity of 81.3% and specificity of 83.3%. The pH measurement method displayed sensitivity and specificity of 89.3% and 100% respectively. Additionally, in terms of estimated direct costs, the pH measurement method incurred a higher cost (USD $8.31) compared to the other methods, with a difference of USD $6.68.
Based on these results, X-ray examination remains the primary method for confirming the placement of nasoenteral tubes recently inserted blindly at the bedside. However, when considering the costs of the evaluated methods, it is advisable to consider the variations in expenses between non-radiological methods and X-ray examinations.
分析护士盲目新插入鼻肠饲管后床边确认导管位置方法的准确性和成本。
三种临床方法（超声、上腹部听诊和pH值测量）与X线摄影相比的诊断准确性研究。还测量了用于确认鼻肠管位置的每种方法的直接成本。
在巴西圣保罗州东北部地区的医院病房中，76名成年患者共接受了87次鼻肠管插入操作。对所有研究参与者按指定顺序进行临床方法检测：超声（作为指标检测），随后是上腹部听诊和pH值测量（也作为指标检测）。
关于鼻肠管准确定位确认的结果如下：超声检查的灵敏度和特异度分别为79.0%和66.7%。上腹部听诊的灵敏度为81.3%，特异度为83.3%。pH值测量方法的灵敏度和特异度分别为89.3%和100%。此外，在估计的直接成本方面，pH值测量方法的成本（8.31美元）高于其他方法，相差6.68美元。
基于这些结果，X线检查仍然是床边盲目插入鼻肠管后确认导管位置的主要方法。然而，在考虑所评估方法的成本时，建议考虑非放射学方法和X线检查之间的费用差异。
