A simple aspiration test to determine the accuracy of oesophageal placement of fine-bore feeding tubes.
Intensive Care Med. 2009 Apr;35(4):722-4
Authors: Ward MM, McEwen AM, Robbins PM, Bennett MJ
OBJECTIVE: To evaluate whether a simple aspiration test can be used to accurately confirm the correct placement of fine-bore feeding tubes in the oesophagus and prevent their inadvertent placement in the bronchial tree. DESIGN: We conducted an ethically approved, randomised, blinded trial to assess the accuracy of a simple aspiration test to differentiate between oesophageal and tracheal placement. SETTING: A tertiary referral cardiothoracic surgical unit. PATIENTS AND PARTICIPANTS: Twenty patients under-going elective cardiac surgery. INTERVENTION: Once anesthetised, a fine-bore feeding tube was inserted into the oesophagus or trachea and a researcher, blinded to the position, then performed the test. This involved attempted aspiration of > or =10 ml of air before and after insufflation of 10 ml of air and comparison with capnography, a test that has been shown to be highly sensitive and specific. MEASUREMENTS AND RESULTS: With this small number of patients, the test accurately differentiated between ten oesophageal and ten tracheal placements. CONCLUSIONS: A simple aspiration test could be a useful adjunct to prevent inadvertent bronchial placement of fine-bore feeding tubes. Careful attention must be paid to the technique to ensure that no false positives occur.
PMID: 18853144 [PubMed - indexed for MEDLINE]