title: Ultrasound-guided nasogastric feeding tube placement in critical care patients.
abstract: BACKGROUND
  Nasogastric feeding tube (NGT) placement is a common practice performed in intensive care units (ICUs). Complications due to the improper placement of NGT are well known. In this prospective descriptive study, the effectiveness of ultrasound (US)-guided NGT placement was investigated.
  
  
  METHODS
  Fifty-six mechanically ventilated patients monitored in the ICU were included. A linear US probe was transversely placed just cranial to the suprasternal notch, and the concentric layers of the esophagus were attempted to be viewed on the posterolateral side of the trachea (generally left) by shifting the probe. If the esophagus can be seen, an attempt was made to insert the NGT under real-time visualization of ultrasonography. Furthermore, gastric placement of the NGT tip was confirmed with abdominal radiograph.
  
  
  RESULTS
  A total of 56 patients were included in the study. For 52 (92.8%), the NGT image was obtained during placement within the esophagus. For 3 (5.3%), the esophagus could not be seen by US, and NGT was placed blindly. For 1 patient, we could not detect passing of the NGT into the stomach despite the successful visualization of esophagus. In this patient, NGT was radiographically detected in the trachea after the procedure.
  
  
  CONCLUSIONS
  This study revealed that passing of the NGT through the esophagus could be visualized at a high rate in real-time US among ICU patients. These data suggest that ultrasonographic visualization of the upper esophagus during NGT insertion can be used as an adjuvant method for confirmation of correct placement.
authors.affiliation: Department of Anesthesiology and Reanimation, Necmettin Erbakan University, Meram Faculty of Medicine, Turkey fundagok@gmail.com.
authors.forename: Funda
authors.initials: F
authors.lastname: Gok
authors.affiliation: Department of Anesthesiology and Reanimation, Necmettin Erbakan University, Meram Faculty of Medicine, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Kilicaslan
authors.affiliation: Department of Anesthesiology and Reanimation, Necmettin Erbakan University, Meram Faculty of Medicine, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Yosunkaya
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014132:Trachea / Q000000981:diagnostic imaging; D014463:Ultrasonography; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: critical care; enteral nutrition; gastrointestinal intubation; nasogastric feeding tube; nutritional support; radiography; ultrasonography