Comparing bedside methods of determining placement of gastric tubes in children

PURPOSE: The purpose of this study was to compare the accuracy and predictive validity of pH, bilirubin, and CO2 in identifying gastric tube placement errors in children. DESIGN AND METHODS: After the tube was inserted into 276 children, the CO2 monitor reading was obtained. Fluid was then aspirated to test pH and bilirubin. RESULTS: Lack of ability to obtain tube aspirate was the best predictor of NG/OG placement errors with a sensitivity of 34.9% and a positive predictive value of 66.7%. Measuring pH, bilirubin, and CO2 of tube aspirate was less helpful. PRACTICE IMPLICATIONS: Healthcare providers should suspect NG/OG tube misplacement when no fluid is aspirated.