RNOtherNursing in critical care2026

Accuracy of Bedside Methods for Preliminary Nasoenteric Tube Tip Localization in Intensive Care: A Prospective Diagnostic Study.

Qianhui Yu, Yanmei Xie, Anshan Yu and 3 others

PMID 42011676

WHAT IT FOUND

Palpation, ultrasound and comparing aspirate pH were better than listening or single pH strips for preliminary tube tip checks, but X-ray confirmation remained required.

Key findings

01Palpation (AUC 0.902), ultrasound (AUC 0.863) and pH difference (AUC 0.808) significantly outperformed auscultation (AUC 0.622) and pH testing (AUC 0.586).

02At the exploratory pH difference cut-off ≥1, sensitivity was 100% and specificity was 61.5%.

03No immediate or delayed adverse events occurred within 24 h post-procedure, and the methods are described as procedural aids only, not replacements for mandatory pre-feeding radiographic confirmation.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

Single centre and one nurse performed insertions and all bedside tests. Results may not apply to other staff or settings. Only 13 patients had gastric placement on radiography. Specificity estimates were imprecise. The pH difference cut-off ≥1 was post hoc and exploratory. The protocol used metoclopramide 10 mg and a 100 mL water bolus. Accuracy may not transfer to other advancement strategies. No adverse events occurred within 24 h. Safety in higher-risk populations was not evaluated. Most participants were mechanically ventilated (86.7%). Findings may not apply to less acute patients.

Declared interests

Supported by the Bureau of Science and Technology of Ganzhou Municipality. The authors declared no conflicts of interest.

The easy way to misread this

Do not read a positive bedside test as proof that feeding can start without radiography. A pH difference ≥1 had 100% sensitivity but only 61.5% specificity, and the authors state these methods are procedural aids only, not replacements for mandatory pre-feeding radiographic confirmation.

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