Sonography as an alternative to radiography for nasogastric feeding tube location

Objective: To evaluate bedside sonographic confirmation of weighted-tip nasogastric feeding tube position, by comparison to radiography. Design and setting: Single-center, double-blind prospective study in a 14-bed medical intensive care unit (ICU) in a 780-bed teaching hospital. Patients: Thirty-three ICU patients undergoing nasogastric tube insertion for enteral feeding. Interventions: The tip of the nasogastric tube was located both by sonography and standard radiography. Measurements and results: The accuracy and procedure times of sonography and radiography for nasogastric tube tip location were compared during 35 procedures in 33 patients. The nasogastric tube tip was visualized by sonography in 34 of 35 procedures (sensitivity 97%) and by radiography in all procedures. The median length of the entire procedure was 24 min and 180 min with sonography and radiography, respectively. Conclusions: Bedside sonography performed by nonradiologists is a sensitive method for confirming the position of weighted-tip feeding nasogastric feeding tubes. It is more rapid than conventional radiography and can easily be taught to ICU physicians. Conventional radiography could be reserved for cases in which sonography is inconclusive.