Assessment of methods to verify correct placement of nasogastric tube in intensive care unit

Insertion of a nasogastric tube (NGT) is one of the most common procedures in intensive care unit (ICU). Therefore, to determine the correct placement of the tube to prevent misplacement in the airways that lead to pneumonia, pneumothorax and even death is important. The aim of this study was to review the diagnostic accuracy of methods verifying correct placement of nasogastric tube and restrictions in ICU. A review of PubMed, Medline and CINAHL databases (About NGT placement verification methods) were conducted to identify peer-reviewed, English language, research studies published between the years 1994 and 2014. In addition, the diagnostic accuracy of methods in detecting inadvertent airway intubation was studied. Quality assessments, data extractions and analysis were completed on all included studies. Although methods for assessing correct NGT location at the bedside are available, each has its limitations (restrictions). Of the 194 English publications, 31 were duplicates. The methods include auscultation (the most common method) and x-ray as the standard method (gold standard) was determined. Other methods include observe visual characteristics of aspirate, PH testing of aspirates, capnography, insertion under direct vision which are associated with restrictions. While none of the existing bedside methods for testing the position of nasogastric tubes is totally reliable, there is evidence to suggest that use more than one method for Confirmation of NGT position for critically ill patients. In addition, more research (to determining new methods) is also needed.