Diagnostic accuracy of the methods carried out to verify nasogastric tube position in mechanically ventilated adult patients: a systematic review protocol

Abstract

Review question/objective The objective of this review is to evaluate the diagnostic accuracy of methods carried out to verify correct positioning of nasogastric (NG) tubes in mechanically ventilated adult patients. More specifically, the objectives are to compare: The diagnostic accuracy of all described methods versus chest X-ray as the gold standard to differentiate between respiratory and gastrointestinal (GI) placement of NG tubes in mechanically ventilated adult patients. Inclusion criteria Types of participants This review will consider studies that include adult mechanically ventilated patients with an NG tube, regardless of the purpose the NG tube serves. Studies concerning neonates and infants will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate any method (index test) performed to verify an NG tube was placed either in the GI tract or in the respiratory tract. Any method revealed by the literature search will be considered for inclusion. It could for example include auscultation, capnography or colorimetric capnography. Since chest X-ray is widely accepted as the gold standard for verifying NG tube placement, 21,22 it will also be considered as the gold standard by this systematic review. Types of outcomes This review will consider studies that include the following outcomes: a test's ability to correctly verify an NG tube to be placed in the GI tract versus the respiratory tract (specificity) and its ability to correctly identify a misplaced tube (sensitivity).