CONFIRMATION OF NASOGASTRIC TUBE PLACEMENT BY COLORIMETRIC INDICATOR DETECTION OF CARBON-DIOXIDE - A PRELIMINARY-REPORT

Background: inadvertent insertion of nasogastric tubes into the trache a and distal airways is reported to range from 0.3% to 15% of insertio ns. Critically ill, mechanically ventilated patients are at a higher r isk for such complications, some of which can be fatal. Objective: Thi s preliminary prospective clinical investigation was designed to deter mine whether a colorimetric carbon dioxide (CO2) indicator device (Eas y-Cap (TM), Nellcor, Inc., Hayward, CA) attached to the proximal end o f a small bore feeding tube (FT) would reliably discriminate between t hose tubes passed into the airways and those passed into the alimentar y tract. Methods: Ten critically ill, mechanically ventilated trauma p atients requiring a FT insertion were evaluated. An Easy-Cap (TM) devi ce was adapted to the proximal port of each FT. Each patient had one t ube inserted per the nasogastric route and then another through the en dotracheal tube while the Easy-Cap (TM) was observed for color changes consistent with the presence of CO2. Results: All transtracheal inser tions showed immediate and unambiguous color changes consistent with t he presence of CO2. None of the nasogastric insertions resulted in ind icator color changes and all were confirmed with radiography (sensitiv ity 100%, specificity 100%, accuracy 100%). Conclusions: This prelimin ary report suggests colorimetric CO2 detection accurately and reliably identifies transtracheal FT insertion.