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Article history:
Received 27 October 2013
Received in revised form 14 March 2014
Accepted 17 March 2014
Keywords:
Nasogastric tube
pH measurement
Auscultatory method
pH
Nasogastric feeding
X-ray
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3. Results
3.1. Study population
The study included 331 intubations in 314 patients. An
X-ray was obtained in 301 intubations. A pH measurement
was performed in 270 intubations. The average age of the
participants was 69 years (range, 1894) (see Table 1).
3.2. Obtaining an aspirate from the nasogastric tube
In 48.6% (n = 161) intubations an aspirate could be
obtained immediately. The additional measures used
(including the aspiration of air into the tube, sidepositioning of the patient and re-aspiration after an hour)
increased the success rate by 33.5% leading to an aspirate
being obtained in 81.6% (n = 270) of intubations (see Fig. 2).
3.3. Use of gastric antacids
The majority of patients were taking antacids (H2
receptor antagonists or proton pump inhibitors). Especially in intensive care, nephrology and surgery the use of
these drugs was high, respectively 84.1% (n = 89), 80%
(n = 12) and 78.8% (n = 26). Without the use of antacids the
average pH was found to be 3.5 (SD: 1.8), with use of
antacids the average was 4.6 (SD: 1.7) (p < 0.05). Analysis
showed that if an aspirate could be obtained (in 270 out of
Intubation
No
Yes
pH 5,5
pH 6
Auscultatory method
Yes
Yes
X-ray control
No
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No
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Table 1
Characteristics of study patients.
Number of patients
n
Total
314
100
Sex
Male
186
59.2
Medical discipline
Neurology
Intensive care
Geriatrics
Oncology
Pulmonary diseases
Nephrology
Surgery
Other
Gastric antacids
74
76
10
46
29
15
33
31
213
23.6
24.2
3.2
14.6
9.2
4.8
10.5
9.9
67.8
Consciousness
Comatose
Somnolent
Conscious
57
80
177
18.2
25.5
56.3
221
110
173
301
66.8
33.2
55.1
90.9
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Table 2
Radiological position of the tubes and results of pH-measurement and the auscultatory method.
Stomach
Oesophagus
Lung
Duodenum
Throat
Total
pH 5.5
n=
%
178
(98.9)
2
(1.1)
0
(0)
0
(0)
0
(0)
180
pH 6
n=
%
49
(79)
2
(3.2)
2
(3.2)
7
(11.3)
1
(1.6)
61
No pH
n=
%
44
(73.3)
9
(15)
1
(1.7)
1
(1.7)
5
(8.3)
60
Loud
Whooshing sound
n=
%
213
(94.2)
5
(2.2)
0
(0)
6
(2.7)
1
(4)
225
Inconclusive
Whooshing sound
n=
%
26
(78.8)
3
(9.1)
2
(6.1)
1
(3)
1
(3)
33
No
Whooshing sound
n=
%
31
(72.1)
6
(14)
1
(2.3)
1
(2.3)
4
(9.3)
43
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