The pH of Feeding Tube Aspirates From Critically Ill Infants.
BACKGROUND
The extent to which gastric acid inhibitors and feedings affect gastric pH in infants is unclear.


OBJECTIVE
To compare pH values of gastric aspirates from infants according to use or no use of gastric acid inhibitors and feedings.


METHODS
Colorimetric pH tests were used to measure the pH of aspirates from feeding tubes in 54 critically ill infants; 29 of the gastric aspirates were from infants who did not receive acid inhibitors or feedings, 13 were from infants who received acid inhibitors but no feedings, 3 were from infants who received feedings but no acid inhibitors, and 5 were from infants who received both acid inhibitors and feedings. The remaining 4 feeding tubes were in nongastric sites.


RESULTS
Individual pH readings of 5.5 or less were found in 97% of the gastric aspirates from infants with no recent feedings or acid inhibitors, 77% of the gastric aspirates from infants who received acid inhibitors, and 67% of the gastric aspirates from infants with recent feedings. Among 2 esophageal aspirates and 2 duodenal aspirates, 1 of each type had a pH less than 5.5. A pH cut point of 5.5 or less did not rule out esophageal or duodenal placement.


CONCLUSIONS
The pH of gastric aspirates from critically ill infants is often 5.5 or less, regardless of the use of acid inhibitors, feedings, or both. Most likely a cut point of 5.5 or less would rule out respiratory placement because tracheal pH is typically 6.0 or higher.
Kathleen L. Meert is a professor of pediatrics, Wayne State University, and chief, Division of Critical Care Medicine, Children's Hospital of Michigan, Detroit, Michigan. Mary Caverly and Lauren M. Kelm are pediatric nurse practitioners at Children's Hospital of Michigan. Norma A. Metheny holds the Dorothy A. Votsmier Endowed Chair in Nursing and is a professor of nursing and associate dean of research, Saint Louis University School of Nursing, St Louis, Missouri.
Kathleen L
KL
Meert
Kathleen L. Meert is a professor of pediatrics, Wayne State University, and chief, Division of Critical Care Medicine, Children's Hospital of Michigan, Detroit, Michigan. Mary Caverly and Lauren M. Kelm are pediatric nurse practitioners at Children's Hospital of Michigan. Norma A. Metheny holds the Dorothy A. Votsmier Endowed Chair in Nursing and is a professor of nursing and associate dean of research, Saint Louis University School of Nursing, St Louis, Missouri.
Mary
M
Caverly
Kathleen L. Meert is a professor of pediatrics, Wayne State University, and chief, Division of Critical Care Medicine, Children's Hospital of Michigan, Detroit, Michigan. Mary Caverly and Lauren M. Kelm are pediatric nurse practitioners at Children's Hospital of Michigan. Norma A. Metheny holds the Dorothy A. Votsmier Endowed Chair in Nursing and is a professor of nursing and associate dean of research, Saint Louis University School of Nursing, St Louis, Missouri.
Lauren M
LM
Kelm
Kathleen L. Meert is a professor of pediatrics, Wayne State University, and chief, Division of Critical Care Medicine, Children's Hospital of Michigan, Detroit, Michigan. Mary Caverly and Lauren M. Kelm are pediatric nurse practitioners at Children's Hospital of Michigan. Norma A. Metheny holds the Dorothy A. Votsmier Endowed Chair in Nursing and is a professor of nursing and associate dean of research, Saint Louis University School of Nursing, St Louis, Missouri. methenna@slu.edu.
Norma A
NA
Metheny
D016638:Critical Illness; D004750:Enteral Nutrition; D005750:Gastric Juice; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal; D011446:Prospective Studies