Use of pH reagent strips to verify gastric tube placement in newborns.
Flávia de Souza Barbosa Dias, Beatriz Pera de Almeida, Beatriz Regina Alvares and 3 others
PMID 31826168WHAT IT FOUND
For newborn gastric tubes, a pH of 5.5 or lower found most correctly placed tubes, but a higher pH did not reliably mean the tube was misplaced.
Use pH strips as a bedside check, not stand-alone confirmation.
Key findings
01The pH test had sensitivity of 96.25% and specificity of 50% compared with radiological images.
02Radiological images showed 160 newborns had the tube correctly placed, and the incorrectly placed cases were one in the cardia and one in the pylorus.
03Use of histamine H2 receptor antagonist was associated with pH above 5.5, but only six subjects used the drug.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only two incorrectly placed tubes occurred, so the test's ability to identify misplaced tubes is uncertain. Only six newborns received histamine H2 blocker, so the association with pH above 5.5 may be inconclusive. The sample was mostly preterm, clinically stable, breathing spontaneously without oxygen, and excluded newborns under minimal manipulation, with congenital malformations or syndromes, or digestive surgery. The authors say the findings are not yet generalizable to patients with intubation, sedation, neurological disorders, different gestational ages, or congenital malformations. The study was done in one public teaching hospital.
The easy way to misread this
Do not use the pH strip alone to confirm newborn gastric tube placement. The test had specificity of 50%, and among the seven newborns with pH above 5.5, six had correctly placed tubes and one had an incorrectly placed tube.