A simple aspiration test to determine the accuracy of oesophageal placement of fine-bore feeding tubes.
OBJECTIVE
To evaluate whether a simple aspiration test can be used to accurately confirm the correct placement of fine-bore feeding tubes in the oesophagus and prevent their inadvertent placement in the bronchial tree.


METHODS
We conducted an ethically approved, randomised, blinded trial to assess the accuracy of a simple aspiration test to differentiate between oesophageal and tracheal placement.


METHODS
A tertiary referral cardiothoracic surgical unit.


METHODS
Twenty patients under-going elective cardiac surgery.


METHODS
Once anesthetised, a fine-bore feeding tube was inserted into the oesophagus or trachea and a researcher, blinded to the position, then performed the test. This involved attempted aspiration of > or =10 ml of air before and after insufflation of 10 ml of air and comparison with capnography, a test that has been shown to be highly sensitive and specific.


RESULTS
With this small number of patients, the test accurately differentiated between ten oesophageal and ten tracheal placements.


CONCLUSIONS
A simple aspiration test could be a useful adjunct to prevent inadvertent bronchial placement of fine-bore feeding tubes. Careful attention must be paid to the technique to ensure that no false positives occur.
Ward
Matthew M
MM
South West Cardiothoracic Centre, Level 6, Derriford Hospital, Plymouth, PL6 8DH, UK.
McEwen
Andrew M
AM
Robbins
Peter M
PM
Bennett
Mark J
MJ
D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000378:metabolism; D004311:Double-Blind Method; D004750:Enteral Nutrition; D004867:Equipment Design; D004947:Esophagus; D005260:Female; D005762:Gastroenterology / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D053120:Respiratory Aspiration / Q000175:diagnosis* / Q000453:epidemiology*; D014132:Trachea
D002245:Carbon Dioxide