Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated Patients
Background: A feeding tube (FT) is routinely placed in critically ill patients, and its correct placement is confirmed with a chest X-ray (CXR), which is considered the gold standard. This study evaluated the diagnostic accuracy of ultrasonography (USG) in verifying FT placement compared to a CXR in...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-08-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/16/2679 |
| _version_ | 1797584966868008960 |
|---|---|
| author | Thanalachumy Ragunathan Rufinah Teo Aliza Mohamad Yusof Siti Nidzwani Mohamad Mahdi Azarinah Izaham Chian Yong Liu Maryam Budiman Syarifah Noor Nazihah Sayed Masri Raha Abdul Rahman |
| author_facet | Thanalachumy Ragunathan Rufinah Teo Aliza Mohamad Yusof Siti Nidzwani Mohamad Mahdi Azarinah Izaham Chian Yong Liu Maryam Budiman Syarifah Noor Nazihah Sayed Masri Raha Abdul Rahman |
| author_sort | Thanalachumy Ragunathan |
| collection | DOAJ |
| description | Background: A feeding tube (FT) is routinely placed in critically ill patients, and its correct placement is confirmed with a chest X-ray (CXR), which is considered the gold standard. This study evaluated the diagnostic accuracy of ultrasonography (USG) in verifying FT placement compared to a CXR in an intensive care unit (ICU). Method: This was a prospective single-blind study conducted on patients admitted to the ICU of a tertiary hospital in Malaysia. The FT placements were verified through a fogging test and USG at the neck and subxiphoid points. The results of confirmation of FT placement through USG were compared with those obtained using CXRs. Results: A total of 80 patients were included in this study. The FT positions were accurately confirmed by overall USG assessments in 71 patients. The percentage of FT placements correctly identified by neck USG was 97.5%, while the percentage of those identified by epigastric USG was 75%. The corresponding patients’ CXRs confirmed correct FT placement in 76 patients. The overall USG assessment had a sensitivity of 92.11% and specificity of 75%, a positive predictive value of 98.59%, and a negative predictive value of 33.33%. The USG findings also showed a significant association between FT size and BMI. FTs with a size of 14Fr were better visualized (<i>p</i> = 0.008), and negative USG findings had a significantly higher BMI (<i>p</i> < 0.001). Conclusion: USG is a simple, safe, and reliable bedside assessment that offers relatively high sensitivity in confirming correct FT placement in critically ill patients. |
| first_indexed | 2024-03-11T00:00:11Z |
| format | Article |
| id | doaj.art-5c6f3f6ae671454ba36c587663f0d9ab |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T00:00:11Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-5c6f3f6ae671454ba36c587663f0d9ab2023-11-19T00:48:32ZengMDPI AGDiagnostics2075-44182023-08-011316267910.3390/diagnostics13162679Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated PatientsThanalachumy Ragunathan0Rufinah Teo1Aliza Mohamad Yusof2Siti Nidzwani Mohamad Mahdi3Azarinah Izaham4Chian Yong Liu5Maryam Budiman6Syarifah Noor Nazihah Sayed Masri7Raha Abdul Rahman8Department of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaDepartment of Anaesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, MalaysiaBackground: A feeding tube (FT) is routinely placed in critically ill patients, and its correct placement is confirmed with a chest X-ray (CXR), which is considered the gold standard. This study evaluated the diagnostic accuracy of ultrasonography (USG) in verifying FT placement compared to a CXR in an intensive care unit (ICU). Method: This was a prospective single-blind study conducted on patients admitted to the ICU of a tertiary hospital in Malaysia. The FT placements were verified through a fogging test and USG at the neck and subxiphoid points. The results of confirmation of FT placement through USG were compared with those obtained using CXRs. Results: A total of 80 patients were included in this study. The FT positions were accurately confirmed by overall USG assessments in 71 patients. The percentage of FT placements correctly identified by neck USG was 97.5%, while the percentage of those identified by epigastric USG was 75%. The corresponding patients’ CXRs confirmed correct FT placement in 76 patients. The overall USG assessment had a sensitivity of 92.11% and specificity of 75%, a positive predictive value of 98.59%, and a negative predictive value of 33.33%. The USG findings also showed a significant association between FT size and BMI. FTs with a size of 14Fr were better visualized (<i>p</i> = 0.008), and negative USG findings had a significantly higher BMI (<i>p</i> < 0.001). Conclusion: USG is a simple, safe, and reliable bedside assessment that offers relatively high sensitivity in confirming correct FT placement in critically ill patients.https://www.mdpi.com/2075-4418/13/16/2679feeding tubeultrasonographyintensive care unitspoint of caresensitivity and specificity |
| spellingShingle | Thanalachumy Ragunathan Rufinah Teo Aliza Mohamad Yusof Siti Nidzwani Mohamad Mahdi Azarinah Izaham Chian Yong Liu Maryam Budiman Syarifah Noor Nazihah Sayed Masri Raha Abdul Rahman Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated Patients Diagnostics feeding tube ultrasonography intensive care units point of care sensitivity and specificity |
| title | Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated Patients |
| title_full | Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated Patients |
| title_fullStr | Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated Patients |
| title_full_unstemmed | Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated Patients |
| title_short | Performance of Point-of-Care Ultrasonography in Confirming Feeding Tube Placement in Mechanically Ventilated Patients |
| title_sort | performance of point of care ultrasonography in confirming feeding tube placement in mechanically ventilated patients |
| topic | feeding tube ultrasonography intensive care units point of care sensitivity and specificity |
| url | https://www.mdpi.com/2075-4418/13/16/2679 |
| work_keys_str_mv | AT thanalachumyragunathan performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT rufinahteo performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT alizamohamadyusof performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT sitinidzwanimohamadmahdi performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT azarinahizaham performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT chianyongliu performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT maryambudiman performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT syarifahnoornazihahsayedmasri performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients AT rahaabdulrahman performanceofpointofcareultrasonographyinconfirmingfeedingtubeplacementinmechanicallyventilatedpatients |