Procedures for measuring and verifying gastric tube placement in newborns: an integrative review.

The review included 17 studies, but only one well-delineated randomized controlled trial, two randomized controlled trials and 14 descriptive studies; no systematic reviews or meta-analyses were found. Accuracy studies did not all measure the same thing: some tested correct placement, others tested incorrect placement, so their values cannot be simply compared. The height-based equation study had only 1% newborns, and the electromagnetic tracing and diaphragm electrical activity studies had very small pediatric samples. Several methods were expensive, and ultrasound was not reviewed here; a pilot report found it unreliable in 10 newborns. Radiology, the reference standard, was not practical for every tube check because of cost, radiation and immediate displacement. All included articles were in English.

The authors declared no conflicts of interest. No funding source is reported.

Do not read this review as proof that bedside checks are as safe as radiology or that NEMU, pH and color checks have been proven in large neonatal trials. The evidence base was mostly descriptive and small, and some studies measured different endpoints, so the recommendations are practical syntheses rather than definitive efficacy findings.