Abstract Number: Esoc2026a1085 Diagnostic Test Accuracy of Bedside Ultrasound for the Verification of Nasogastric Tube Position in Non-Ventilated Adult Patients: A Systematic Review

Background and aims Nasogastric tube (NGT) placement is common in stroke care, however incorrect positioning posing a serious risk of aspiration pneumonia. When gastric aspirate pH testing is unsuccessful, chest x-ray is the current reference standard for NGT position verification; however, this process can take many hours leaving stroke patients without fluids and nutrition for extended periods of time. Bedside ultrasound has emerged as a potential alternative, but existing reviews have largely focused on ventilated or paediatric populations. This review evaluates the diagnostic accuracy of bedside ultrasound for confirming NGT position in non-ventilated adult patients. Methods A systematic review of diagnostic test accuracy studies will be conducted following PRISMA-DTA guidance. Electronic databases including Embase, MEDLINE, the Cochrane Library, and ClinicalTrials.gov were searched. Eligible studies included non-ventilated adult patients requiring NGT position confirmation, using bedside ultrasound as the index test and chest x-ray as the reference standard. Two reviewers independently screened studies, extract data, and assess methodological quality using GRADE, QUADAS-2, and QUADAS-C tools. Extracted outcomes including sensitivity, specificity, positive and negative predictive values were assessed. Results A total of 64 trials were initally identified, after screening 5 trials were deemed suitable for this review including a total of 802 patients. overall sensitivites ranging from 64% - 99.8% Conclusions This review highlighting an evidence gap that warrents exploration. Bedside ultrasound may offer a faster, safer, and more cost-effective alternative to chest x-ray, with potential benefits for patient experience, clinical pathways, and healthcare resource utilisation. Further research using newer point-of-care ultrasound scanners and defind protocols should be explored Conflict of interest Surabhi Saxena nothing to disclose Holly Maguire nothing to disclose