The distance to the stomach for feeding tube placement in children predicted from regression on height.
ABSTRACT Nurses use several external measures referenced to the head and chest to gauge the insertion distance for orogastric and nasogastric (NG) tubes. Few of the measures have been tested. However, in previous studies height was the external measure most correlated with esophageal length both in children and adults. In this study, the ability of previously published regression equations on height to predict esophageal length for NG-tube insertion in 107 children was evaluated. The regression equations were examined for stability, predictive performance, and the likely positions of the tube. The data were heights and esophageal lengths obtained from esophageal manometry records and hospital charts. The predicted values for nasal insertions were biased and averaged 2.4 cm too long (R2prediction = .56, n = 30). Prediction errors greater than 5 cm in absolute value occurred in 25% of the nasally-referenced sample. The predicted values represented overestimates in 18 nasally referenced cases that were 11.5% longer on the average than the measured esophageal lengths. In contrast, the predicted values for the oral insertions were unbiased (R2prediction = .92, n = 77), and gave accurate predictions in the majority of cases. Eighty percent of the oral predictions were within +/- 1.5 cm of the measured esophageal length and represented percentage errors between 0 and 7% (M = 3%, n = 50).
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ABSTRACT: Nineteen patients with abnormal gastroesophageal reflux (13 with and six without hiatal hernia) had esophageal manometry and simultaneous 24-hour monitoring of esophageal pH and intra-abdominal pressure (IAP). Only 8% of all IAP challenges induced a reflux episode. This incidence increased to 13% in patients with a distal esophageal sphincter (DES) pressure of less than 5 mm Hg and an abdominal esophageal length of less than 1 cm, whereas it was only 6% in patients with a greater DES pressure and a longer abdominal esophagus. At the same time, there was an average of 2.7 reflux episodes per hour, of which 38.7% were caused by a challenge of IAP indicating that other mechanisms, besides changes in abdominal pressure, can cause reflux. There was no difference in DES pressure, length of abdominal esophagus, and the effect of IAP challenges in patients with and those without a hiatal hernia.Archives of Surgery 05/1980; 115(4):534-9. · 4.10 Impact Factor
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ABSTRACT: This study was aimed at identifying non-invasive techniques and criteria for predicting the proper length for insertion of a nasogastric tube for tube feeding so that the tube tip would be located in the fundus or body for the stomach. A review of literature and existing practices revealed unsubstantiated and discrepant methods currently in use and justified the need for this research. The study involved relating several external body measurements to a measurement from the tip of the nose to the lower esophageal sphincter, via the esophagus, in 99 adult cadavers and 5 normal adult volunteers. A variety of analyses including stepwise multiple regression, were used and are presented. A formula is presented and is stated to provide a 91% confidence level of tube tip placement in the stomach between 1 and 10 cm. This is compared to a confidence level of 72% using the traditional nose to ear to xiphoid measurement. The formula is ( (NEX-50cm) /2)) + 50cm where NEX is the distance from the tip of the nose to the earlobe to the xiphoid. Two methods for simple mechanical clinical application are described.Journal of Parenteral and Enteral Nutrition 01/1979; 3(3):160-3. · 2.49 Impact Factor
- Image--the journal of nursing scholarship 02/1987; 19(1):16-9.