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The Use of Ultrasonography for Verifying Gastric Tube Placement in Newborns

Dias, Fla'via de Souza Barbosa, PhD, RN; Alvares, Beatriz Regina, PhD, MD; Jales, Rodrigo Menezes, PhD, MD; Franco, Aline Patricia Vicente, RN; Silva, Jessica Emile Fabri da, RN; Fabene, Suelen Mara Silva, RN; Caldas, Jamil Pedro de Siqueira, PhD, MD; Carmona, Elenice Valentim, PhD, RN

Section Editor(s): Dowling, Donna PhD, RN; ; Thibeau, Shelley PhD, RNC-NIC;

doi: 10.1097/ANC.0000000000000553
Original Research

Background: The use of gastric tubes in newborns admitted to a neonatal intensive care unit is fairly high, and there is a risk of serious complications related to this procedure.

Purpose: Considering the need to find a method that does not involve the patient's exposure to radiation, this study aimed to evaluate the diagnostic accuracy of ultrasonography for verifying gastric tube placement in newborns.

Methods: This was a prospective, double-blind, observational study performed in a neonatal intensive care unit, in which 159 infants had gastric intubation using ultrasound examination and radiological imaging, to verify positioning. Results were analyzed in terms of diagnostic accuracy.

Results: The tubes were correctly positioned in 157 cases (98.7%), according to radiological images, and in 156 cases (98.1%), according to ultrasound. The sensitivity analysis was 0.98 and the positive predictive value was 0.99. It was not possible to perform a specificity analysis, as there were not enough negative cases in the sample.

Implications for Practice: The use of ultrasonography to identify correct positioning of gastric tubes in infants and newborns shows good sensitivity.

Implications for Research: It was not possible to evaluate the ultrasonography specificity; further studies with greater samples are probably necessary, so that this objective can be achieved.

Video Abstract available at

School of Nursing (Dr Dias, Ms Franco, and Dr Carmona), School of Medical Sciences, Department of Obstetrics and Gynecology (Dr Jales), Department of Pediatrics (Dr Caldas), Department of Radiology (Dr Alvares) and Woman's Hospital CAISM (Mss Silva and Fabene) - University of Campinas, São Paulo, Brazil.

Correspondence: Flávia de Souza Barbosa Dias, PhD, RN, Rua Tessália Vieira de Camargo, 126 Cidade Universitária, Campinas/SP 13083-887, Brazil (

The authors declare no conflicts of interest.

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© 2019 by The National Association of Neonatal Nurses