Weight-Based Estimation of Insertion Length of the Nasogastric Tube in Extremely Low Birth-Weight Infants.
Algorithms
Body Weight
Enteral Nutrition
/ instrumentation
Female
Humans
Infant, Extremely Low Birth Weight
Infant, Newborn
Intensive Care Units, Neonatal
/ standards
Intensive Care, Neonatal
/ standards
Intubation, Gastrointestinal
/ instrumentation
Male
Practice Guidelines as Topic
Pregnancy
Prospective Studies
Journal
Advances in neonatal care : official journal of the National Association of Neonatal Nurses
ISSN: 1536-0911
Titre abrégé: Adv Neonatal Care
Pays: United States
ID NLM: 101125644
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
pubmed:
7
12
2019
medline:
18
12
2020
entrez:
7
12
2019
Statut:
ppublish
Résumé
Nasogastric (NG) tubes are used in the neonatal intensive care unit (NICU) for various indications. However, evidence of the best practice for estimating the NG tube insertion length in extremely low birth-weight (ELBW) infants is limited. To determine a weight-based estimation formula of NG tube length in ELBW infants. This prospective study was performed at a single-center level III neonatal intensive care unit. Low birth-weight infants admitted between May 2009 and May 2010 who required radiography for clinical reasons were included. Radiographs of participants whose current body weights (BWs) were less than 2500 g were reviewed, and the appropriate ideal insertion length of the NG tube adjusted based on radiographs and the infant's current BW was assessed. A regression model was used to determine the ideal insertion length of the NG tube with respect to the current BW. Overall, 533 radiographs (152 patients weighing 422-2486 g) were analyzed. Among the patients, 246 had BWs less than 1000 g and 287 had BWs more than 1000 g. Formulas that predicted NG tube length (centimeters) were derived as follows: (5 × weight [kg] + 10 [BW < 1.0 kg]) or (3 × weight [kg] + 12.5 [1.0 < BW <2.5 kg]). The application of the weight-based formula for estimating the NG tube length derived from the present study together with commonly used morphological methods may improve the accuracy of the NG tube insertion procedure in ELBW infants. Further studies in other cohorts are needed.
Sections du résumé
BACKGROUND
BACKGROUND
Nasogastric (NG) tubes are used in the neonatal intensive care unit (NICU) for various indications. However, evidence of the best practice for estimating the NG tube insertion length in extremely low birth-weight (ELBW) infants is limited.
PURPOSE
OBJECTIVE
To determine a weight-based estimation formula of NG tube length in ELBW infants.
METHODS
METHODS
This prospective study was performed at a single-center level III neonatal intensive care unit. Low birth-weight infants admitted between May 2009 and May 2010 who required radiography for clinical reasons were included. Radiographs of participants whose current body weights (BWs) were less than 2500 g were reviewed, and the appropriate ideal insertion length of the NG tube adjusted based on radiographs and the infant's current BW was assessed. A regression model was used to determine the ideal insertion length of the NG tube with respect to the current BW.
RESULTS
RESULTS
Overall, 533 radiographs (152 patients weighing 422-2486 g) were analyzed. Among the patients, 246 had BWs less than 1000 g and 287 had BWs more than 1000 g. Formulas that predicted NG tube length (centimeters) were derived as follows: (5 × weight [kg] + 10 [BW < 1.0 kg]) or (3 × weight [kg] + 12.5 [1.0 < BW <2.5 kg]).
IMPLICATIONS FOR PRACTICE
CONCLUSIONS
The application of the weight-based formula for estimating the NG tube length derived from the present study together with commonly used morphological methods may improve the accuracy of the NG tube insertion procedure in ELBW infants.
IMPLICATIONS FOR RESEARCH
CONCLUSIONS
Further studies in other cohorts are needed.
Identifiants
pubmed: 31809277
doi: 10.1097/ANC.0000000000000692
pii: 00149525-202004000-00018
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E31-E34Références
Ellett ML, Maahs J, Forsee S. Prevalence of feeding tube placement errors & associated risk factors in children. MCN Am J Matern Child Nurs. 1998;23(5):234–239.
de Boer JC, Smit BJ, Mainous RO. Nasogastric tube position and intragastric air collection in a neonatal intensive care population. Adv Neonatal Care. 2009;9(6):293–298.
Metheny NA, Meert KL, Clouse RE. Complications related to feeding tube placement. Curr Opin Gastroenterol. 2007;23(2):178–182.
Hanafy Eel-D, Ashebu SD, Naqeeb NA, Nanda HB. Pericardial sac perforation: a rare complication of neonatal nasogastric tube feeding. Pediatr Radiol. 2006;36(10):1096–1098.
Filippi L, Pezzati M, Poggi C. Use of polyvinyl feeding tubes and iatrogenic pharyngo-oesophageal perforation in very-low-birthweight infants. Acta Paediatr. 2005;94(12):1825–1828.
Farrington M, Lang S, Cullen L, Stewart S. Nasogastric tube placement verification in pediatric and neonatal patients. Pediatr Nurs. 2009;35(1):17–24.
Society of Pediatric Nurses (SPN) Clinical Practice Committee; SPN Research Committee, Longo MA. Best evidence: nasogastric tube placement verification. J Pediatr Nurs. 2011;26(4):373–376.
Beckstrand J, Cirgin Ellett ML, McDaniel A. Predicting internal distance to the stomach for positioning nasogastric and orogastric feeding tubes in children. J Adv Nurs. 2007;59(3):274–289.
Cirgin Ellett ML, Cohen MD, Perkins SM, Smith CE, Lane KA, Austin JK. Predicting the insertion length for gastric tube placement in neonates. J Obstet Gynecol Neonatal Nurs. 2011;40(4):412–421.
Ellett ML, Cohen MD, Perkins SM, Croffie JM, Lane KA, Austin JK. Comparing methods of determining insertion length for placing gastric tubes in children 1 month to 17 years of age. J Spec Pediatr Nurs. 2012;17(1):19–32.
Freeman D, Saxton V, Holberton J. A weight-based formula for the estimation of gastric tube insertion length in newborns. Adv Neonatal Care. 2012;12(3):179–182.
Nguyen S, Fang A, Saxton V, Holberton J. Accuracy of a weight-based formula for neonatal gastric tube insertion length. Adv Neonatal Care. 2016;16(2):158–161.
Parker LA, Withers JH, Talaga E. Comparison of Neonatal Nursing Practices For Determining Feeding Tube Insertion Length And Verifying Gastric Placement With Current Best Evidence. Adv Neonatal Care. 2018;18(4):307–317.
Kiserud T, Benachi A, Hecher K, et al. The World Health Organization fetal growth charts: concept, findings, interpretation, and application. Am J Obstet Gynecol. 2018;218(2S):S619–S629.