title: Does Bedside Sonography Effectively Identify Nasogastric Tube Placements in Pediatric Critical Care Patients?
abstract: BACKGROUND
  A nasogastric tube (NGT) insertion is a common procedure in intensive care units, with some serious complications that result from the malposition of the NGT tip. This pilot study was designed to investigate the efficiency of ultrasound in verifying correct NGT placement and to compare these results with radiographic findings.
  
  
  METHODS
  This was a single-center, double-blind prospective study of patients who had received an NGT in the pediatric critical care unit. Twenty-one patients aged 1 month to 18 years were included in this study. All NGTs were inserted by the same critical care physician. After insertion, the physician first confirmed NGT placement by the auscultation of the epigastrium following the insufflation of air. Confirmation was supplemented with an abdominal radiograph. A radiologist who was unaware of the radiographic findings performed bedside sonography on all patients and verified the location of the NGTs. The findings from these 2 physicians were then compared.
  
  
  RESULTS
  NGTs were inserted without any complications, and none of the NGTs were positioned in the respiratory tract in any of the patients. All NGT tips were visualized by radiography and sonography with a sensitivity of 100%.
  
  
  CONCLUSIONS
  Bedside sonography performed by a radiologist is an effective and sensitive diagnostic procedure for confirming the correct NGT position in patients in the pediatric critical care unit.
authors.affiliation: 1 Ondokuz Mayis University, Faculty of Medicine, Department of Radiology, Outpatient Anesthesia Service, Samsun, Turkey.
authors.forename: Yunus Oktay
authors.initials: YO
authors.lastname: Atalay
authors.affiliation: 2 Kirikkale High Specialty Hospital, Department of Radiology, Kirikkale, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Aydin
authors.affiliation: 3 Ondokuz Mayis University, Faculty of Medicine, Department of Pediatrics, Samsun, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Ertugrul
authors.affiliation: 4 Aksaray Goverment Hospital, Department of Radiology, Aksaray, Turkey.
authors.forename: Selim Baris
authors.initials: SB
authors.lastname: Gul
authors.affiliation: 5 Ondokuz Mayis University, Faculty of Medicine, Department of Radiology, Samsun, Turkey.
authors.forename: Ahmet Veysel
authors.initials: AV
authors.lastname: Polat
authors.affiliation: 6 Ondokuz Mayis University, Faculty of Medicine, Pediatric Intensive Care Unit, Samsun, Turkey.
authors.forename: Muhammet Sukru
authors.initials: MS
authors.lastname: Paksu
mesh_terms: D002648:Child; D003422:Critical Care; D004311:Double-Blind Method; D004750:Enteral Nutrition; D006801:Humans; D007441:Intubation, Gastrointestinal; D015588:Observer Variation; D010865:Pilot Projects; D019095:Point-of-Care Systems; D011446:Prospective Studies; D014463:Ultrasonography
keywords: enteral nutrition; intensive care units; nasogastric tube; patient safety; pediatrics; radiography; ultrasonography