title: Predicting internal distance to the stomach for positioning nasogastric and orogastric feeding tubes in children.
abstract: OBJECTIVE
  This paper is a report of a study to examine how well direct morphological distances commonly used for nasogastric or orogastric tube insertion and other methods perform as predictors of the internal distance to the targeted position for the tube pores in the stomach.
  
  
  BACKGROUND
  Previous studies with very small samples have indicated that commonly used distances give malplacements, either above the oesophagogastric junction or below the body of the stomach, perhaps as much as 33% of the time.
  
  
  METHODS
  We compared the predicted distances to the endoscopic and manometric distances to the oesophagogastric junction and to the body of the stomach in a prospective study of 494 children, 2 weeks to 19 years (231 months) of age. Data were collected from 1991 to 1998 and in 2005.
  
  
  RESULTS
  The nose-ear-xiphoid distance commonly used in nursing, and other morphological distances, often gave estimates that were either shorter than that to the oesophagogastric junction or longer than that to the distal margin of the body of the stomach. Age-specific methods for predicting the distance to the body of the stomach based on height gave highly accurate predictions of the internal distances.
  
  
  CONCLUSIONS
  Age-specific methods have the potential to predict accurately the distances to the body of the stomach in 98.8% of children from 0.5 to 100 months of age and in 96.5% of children over 100 months of age. Where age-specific prediction methods cannot be used, the next best choice is the nose or mouth to ear-mid-xiphoid-umbilicus span.
authors.affiliation: School of Nursing, Indiana University, Indianapolis, IN, USA. jbeckstr@iupui.edu
authors.forename: Jan
authors.initials: J
authors.lastname: Beckstrand
authors.forename: Marsha L
authors.initials: ML
authors.lastname: Cirgin Ellett
authors.forename: Anna
authors.initials: A
authors.lastname: McDaniel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D004750:Enteral Nutrition / Q000295:instrumentation / Q000451:nursing / Q000592:standards*; D004943:Esophagogastric Junction / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008365:Manometry / Q000295:instrumentation*; D011446:Prospective Studies; D015203:Reproducibility of Results; D013270:Stomach / Q000033:anatomy & histology*; D014989:Xiphoid Bone / Q000033:anatomy & histology