Real-time Assessment of Nasogastric Tube Position Using POCUS in Mechanically Ventilated Patients and its Comparison to Gold Standard Method (Chest X-ray)

INTRODUCTION: Nasogastric tube (NGT) placement is the most frequently used method for enteral feeding and drug administration in mechanically ventilated patients. Blind insertion of NGT can have complication rate of 0.3% – 8%.(1) In anesthetized patients, the insertion and confirmation of NGT has a failure rate of almost 50% on the first attempt in neutral head position. Literature demonstrates mechanical ventilation as the most substantial risk factor for NGT misplacement.(2) OBJECTIVES: Assessment of NGT position using POCUS in mechanically ventilated patients and its comparison to Chest X-ray. MATERIALS AND METHODOLOGY: Two hundred adult patients meeting the inclusion criteria will be enrolled in the study. The patients will be placed in the supine and sniffing position before the procedure. Sonographic examination will be performed by a competent operator, who is experienced in airway ultrasound. A high-frequency linear US probe will be transversely placed over the suprasternal notch. When an image of the empty esophagus will be obtained, a second individual will insert an NGT of 10–14 Fr in thickness from the appropriate nostril of the patient by adjusting the nasal passage. An attempt will be made to visualize its passage from the esophagus lumen with US. The same patients will undergo a chest X-ray as per the ICU and hospital policy. The results of the ultrasound and chest X-ray will then be compared. RESULTS: As the study is still underway, the results will be shared at the time of presentation. DISCUSSION: As the study is still underway, discussion will be shared at the time of presentation.