title: Colorimetric capnography, a new procedure to ensure correct feeding tube placement in the intensive care unit: an evaluation of a local protocol.
abstract: OBJECTIVE
  Radiography is the criterion standard method to ensure correct placement of a feeding tube. Recently, excellent results were reported using a combination of colorimetric capnography and epigastric auscultation, but the impact of this technique has not been studied to date. Objectives were to assess whether our local procedure, using colorimetric capnography to ensure proper feeding tube placement, improves the patient's care, satisfies nurses, and decreases costs compared with the standard procedure requiring systematic radiography.
  
  
  METHODS
  We performed a monocentric prospective observational study in a medical intensive care unit over a 4-month period. Feeding tube placement was assessed by colorimetric capnography and epigastric auscultation. Radiography was performed when epigastric auscultation was inconclusive.
  
  
  RESULTS
  A total of 69 feeding tubes were placed in 44 patients. Radiography was required in 10.1% of the cases. The new procedure decreased costs ($33.37 ± 13.96 vs $45.92, P < .0001) and was less time consuming (11.6 ± 20.5 minutes vs 87.3 ± 45.2 minutes, P < .0001) than using systematic radiography. All nurses reported confidence in the procedure, which improved the organization of their care.
  
  
  CONCLUSIONS
  The use of colorimetric capnography and epigastric auscultation to confirm feeding tube placement improves nurse's organization of care, saves time, and decreases costs.
authors.affiliation: Service de Réanimation Médicale, Hôpital Saint-Antoine (AP-HP), 184 rue du faubourg Saint-Antoine, 75571, Paris Cedex 12, France. galbois@gmail.com
authors.forename: Arnaud
authors.initials: A
authors.lastname: Galbois
authors.forename: Paola
authors.initials: P
authors.lastname: Vitry
authors.forename: Hafid
authors.initials: H
authors.lastname: Ait-Oufella
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Baudel
authors.forename: Bertrand
authors.initials: B
authors.lastname: Guidet
authors.forename: Eric
authors.initials: E
authors.lastname: Maury
authors.forename: Georges
authors.initials: G
authors.lastname: Offenstadt
mesh_terms: D000368:Aged; D001314:Auscultation; D002153:Calorimetry, Indirect; D019296:Capnography / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D013902:Radiography, Thoracic