Confirmation of Nasogastric Tube Placement via Bedside Ultrasound in a Pediatric Intensive Care Unit

Abstract

Introduction: Nasogastric tube (NGT) placement is a common procedure in pediatric intensive care and requires accurate verification to avoid complications. Traditional methods such as auscultation and radiography pose limitations such as unreliability and radiation exposure. The aim of this study was to confirm the placement of NGT using bedside ultrasonography (USG). Methods: A prospective study was conducted in a tertiary pediatric intensive care unit (PICU) using bedside USG to confirm NGT positioning. The study included 46 patients, with procedures ranging from November 2023 to January 2024. Placement confirmation techniques included USG visualization and the air bolus method when necessary. Results: All 68 NGT insertions were successfully visualized using USG. The median age of patients was 18 months, with the most common admissions being pneumonia and septic shock. An air bolus was used in 13.2% of the cases to indirectly confirm placement. Conclusion: Bedside USG is an effective and safe alternative for confirming NGT placement in the PICU, minimizing the risk of radiation, and leveraging the benefits of immediate and accurate bedside assessment. This method can replace radiography as the new standard for NGT placement confirmation.

Keywords

• nasogastric tube
• pediatric intensive care units
• radiography
• ultrasonography