Chen Yunxia, Liang Qianqian, Sheng Zhiyuan, Xu Mengmin, Li Ying, Meng Xiaobing, Hao Xiaodi, Zhao Wenli, Li Zhen, Yang Yuji, Feng Yingpu
Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, PR China.
Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, PR China.
Intensive Crit Care Nurs. 2025 Oct;90:104034. doi: 10.1016/j.iccn.2025.104034. Epub 2025 Apr 12.
To evaluate the accuracy of pressure at the gastric tube tip manometry for confirming nasogastric (NG) tube placement in neurocritical care patients.
A total of 150 patients who underwent NG tube placement in the Neurocritical Care Unit (NICU) of a tertiary hospital in Henan Province from August to December 2024 were consecutively enrolled. After tube insertion, pressure at the gastric tube tip manometry was used to assess tube position, with accuracy confirmed by chest X-ray, the gold standard. The method's consistency, specificity, sensitivity, and area under the receiver operating characteristic (ROC) curve were then analyzed.
Pressure at the gastric tube tip manometry demonstrated exceptional diagnostic performance, with an AUC of 0.992 (95 % CI: 0.979-1.000), 100 % sensitivity, and 98.39 % specificity. In patients with artificial airways, an AUC of 0.989 (95 % CI: 0.975-1.000) was achieved, with 100 % sensitivity and 97.87 % specificity. For patients without artificial airways, specificity was 100 %, but sensitivity and AUC could not be calculated. In mechanically ventilated patients, an AUC of 0.987 (95 % CI: 0.965-1.000) was achieved, with 100 % sensitivity and 97.37 % specificity. In contrast, in non-mechanically ventilated patients, an AUC of 1.000 (95 % CI: 1.000-1.000) was observed, with both sensitivity and specificity at 100 %. When stratified by Glasgow Coma Scale (GCS) scores, patients with a GCS ≤ 8 had an AUC of 0.990(95 % CI: 0.973-1.000), with 100 % sensitivity and 97.96 % specificity, while those with a GCS of 9-15 showed a perfect AUC of 1.000(95 % CI: 1.000-1.000), with both sensitivity and specificity at 100 %.
Pressure at the gastric tube tip manometry, unaffected by the presence of fluid in the tube, is a highly reliable method for verifying NG tube placement in neurocritical care patients and exhibits excellent concordance with chest X-ray results.
The pressure at the gastric tube tip manometry method provides an accurate, rapid, and non-invasive means of confirming NG tube placement in neurocritical care patients, particularly those without artificial airways. The method shows great practical potential in enhancing the accuracy and efficiency of NG tube placement verification.
评估胃管尖端测压法在神经重症监护患者中确认鼻胃管（NG）置入位置的准确性。
连续纳入2024年8月至12月在河南省一家三级医院神经重症监护病房（NICU）接受NG管置入的150例患者。插管后，采用胃管尖端测压法评估导管位置，通过胸部X线（金标准）确认准确性。然后分析该方法的一致性、特异性、敏感性以及受试者操作特征（ROC）曲线下面积。
胃管尖端测压法显示出卓越的诊断性能，曲线下面积（AUC）为0.992（95%可信区间：0.979 - 1.000），敏感性为100%，特异性为98.39%。在有人工气道的患者中，AUC为0.989（95%可信区间：0.975 - 1.000），敏感性为100%，特异性为97.87%。对于没有人工气道的患者，特异性为100%，但无法计算敏感性和AUC。在机械通气患者中，AUC为0.987（95%可信区间：0.965 - 1.000），敏感性为100%，特异性为97.37%。相比之下，在非机械通气患者中，观察到AUC为1.000（95%可信区间：1.000 - 1.000），敏感性和特异性均为100%。按格拉斯哥昏迷量表（GCS）评分分层时，GCS≤8分的患者AUC为0.990（95%可信区间：0.973 - 1.000），敏感性为100%，特异性为97.96%，而GCS为9 - 15分的患者AUC完美为1.000（95%可信区间：1.000 - 1.000），敏感性和特异性均为100%。
胃管尖端测压法不受管内液体存在的影响，是验证神经重症监护患者NG管置入位置的高度可靠方法，与胸部X线结果具有良好的一致性。
胃管尖端测压法为确认神经重症监护患者，尤其是没有人工气道的患者的NG管置入位置提供了一种准确、快速且无创的方法。该方法在提高NG管置入验证的准确性和效率方面显示出巨大的实际潜力。
