Use of a pressure gauge to differentiate gastric from pulmonary placement of nasoenteral feeding tubes

This study was conducted to determine the reliability and validity of using a pressure gauge to differentiate gastric from pulmonary placement of nasoenteral tubes in nonmechanically ventilated patients. It was anticipated that on inhalation, tubes properly placed in the gastric region would yield positive readings owing to positive gastric pressures. Conversely, tubes that were inadvertently placed in the pulmonary system should yield negative pressure readings owing to the negative pulmonary pressures that exist on inhalation. Forty-six subjects were enrolled in the study. Of those, 44 had positive gauge readings, and x-ray results showed that these nasoenteral tubes were in the gastric region. Two patients had negative gauge readings, and the x-rays for both of these subjects demonstrated that the nasoenteral tubes were in the pulmonary system. Thus, the findings were consistent with what was anticipated. Despite the small sample size, the results of this study indicate that this method of assessing nasoenteral tube placement may be a safe, reliable, and cost-effective method of differentiating gastric from pulmonary tube placement in this patient population.