Evidence map›Paper›PMID 35653380›Full record

Observational studyPloS one2022

Nasogastric tube in mechanical ventilated patients: ETCO2 and pH measuring to confirm correct placement. A pilot study.

Samuele Ceruti, Simone Dell'Era, Francesco Ruggiero, Giovanni Bona, Andrea Glotta, Maira Biggiogero, Edoardo Tasciotti, Christoph Kronenberg, Gianluca Lollo, Andrea Saporito

Registry-linked trialOpen access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03934515 (Tracheal etCO2 Level and Gastric pH Level Measurements During the Correct Naso-gastric Tube Placement in Unconscious Patients. A Physiological, Prospective, Observational Study), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03934515 completednot on this map

Tracheal etCO2 Level and Gastric pH Level Measurements During the Correct Naso-gastric Tube Placement in Unconscious Patients. A Physiological, Prospective, Observational Study

TypeobservationalSponsorClinica Luganese MoncuccoRan2020 to 2021Enrolled85ConditionsGastric Feeding Tube, Blood Gas Monitoring, Transcutaneous, pHArmsetCO2, pH
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Samuele CerutiDepartment of Critical Care, Clinica Luganese Moncucco, Lugano, Ticino, Switzerland.ORCID 0000-0003-4146-3434
Simone Dell'EraService of Anesthesiology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Ticino, Switzerland.
Francesco RuggieroDepartment of Internal Medicine, Clinica Luganese Moncucco, Lugano, Ticino, Switzerland.
Giovanni BonaClinical Research Unit, Clinica Luganese Moncucco, Lugano, Ticino, Switzerland.ORCID 0000-0003-0771-5431
Andrea GlottaDepartment of Critical Care, Clinica Luganese Moncucco, Lugano, Ticino, Switzerland.
Maira BiggiogeroClinical Research Unit, Clinica Luganese Moncucco, Lugano, Ticino, Switzerland.
Edoardo TasciottiService of Anesthesiology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Ticino, Switzerland.
Christoph KronenbergService of Anesthesiology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Ticino, Switzerland.
Gianluca LolloDepartment of Gastroenterology and Hepatology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Ticino, Switzerland.
Andrea SaporitoService of Anesthesiology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Ticino, Switzerland.
Clinica Luganese Moncucco · CHOspedale Regionale di Bellinzona e Valli · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNasogastric tube (NGT) placement is a procedure commonly performed in mechanically ventilated (MV) patients. Chest X-Ray is the diagnostic gold-standard to confirm its correct placement, with the downsides of requiring MV patients' mobilization and of intrinsic actinic risk. Other potential methods to confirm NGT placement have shown lower accuracy compared to chest X-ray; end-tidal CO2 (ETCO2) and pH analysis have already been singularly investigated as an alternative to the gold standard. Aim of this study was to determine threshold values in ETCO2 and pH measurement at which correct NGT positioning can be confirmed with the highest accuracy. MATERIALS &

methodsThis was a prospective, multicenter, observational trial; a continuous cohort of eligible patients was allocated with site into two arms. Patients underwent general anesthesia, orotracheal intubation and MV; in the first and second group we respectively assessed the difference between tracheal and esophageal ETCO2 and between esophageal and gastric pH values.

resultsFrom November 2020 to March 2021, 85 consecutive patients were enrolled: 40 in the ETCO2 group and 45 in the pH group. The ETCO2 ROC analysis for predicting NGT tracheal misplacement demonstrated an optimal ETCO2 cutoff value of 25.5 mmHg, with both sensitivity and specificity reaching 1.0 (AUC 1.0, p < 0.001). The pH ROC analysis for predicting NGT correct gastric placement resulted in an optimal pH cutoff value of 4.25, with mild diagnostic accuracy (AUC 0.79, p < 0.001). DISCUSSION: In patients receiving MV, ETCO2 and pH measurements respectively identified incorrect and correct NGT placement, allowing the identification of threshold values potentially able to improve correct NGT positioning.

trial registrationNCT03934515 (www.clinicaltrials.gov).

Indexed as

Intubation, GastrointestinalRespiration, ArtificialHumansHydrogen-Ion ConcentrationPilot ProjectsProspective Studies

Identifiers

PMID35653380
PMCPMC9162373
OpenAlexW4281609625

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.