Research on the application of gastrointestinal ultrasound combined with gas-water alternating injection in the positioning of nasointestinal tube for severe patients

Abstract

Objective To assess the value of bedside gastrointestinal ultrasound combined with gas-water alternate injection on nasointestinal tube positioning in critically ill patients. Methods A total of 62 critically ill patients requiring post-pyloric enteral nutrition admitted to the intensive care unit in our Hospital from May 1, 2017 to December 1, 2017 were enrolled. Nasointestinal tubes were blindly inserted in a bedside setting. Then, we evaluated the nasointestinal tube position using both an ultrasound with gas-water alternate injection and the traditional auscultation method after gas perfusion. Abdominal X-ray imaging was also performed in all cases as the gold standard, and the sensitivities, specificities, positive predictive values, negative predictive values, and accuracies of the tested methods were obtained. Results Sixty-two patients were confirmed by X-ray, wherein 55 were successfully catheterized and 7 were ectopic. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound-assisted gas-water injection were 90.9%, 100%, 100%, 58.3%, and 91.9%, respectively, which were all higher than those of traditional gas perfusion auscultation (P<0.05). Conclusion The bedside gastrointestinal ultrasound with gas-water alternate injections for nasointestinal tube positioning in critically ill patients has a certain clinical value. Key words: Intensive care; nasointestinal tube; Ultrasonography; gastrointestinal