Diagnostic accuracy of gastric aspirate pH measurement for verifying nasogastric tube placement in children receiving home enteral nutrition: An observational diagnostic accuracy study
Nutrition in Clinical Practice, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1002/ncp.70185
- Dergi Adı: Nutrition in Clinical Practice
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: fluoroscopy, gastric aspirate pH, home enteral nutrition, nasogastric tube, pediatric nursing
- Hacettepe Üniversitesi Adresli: Evet
Özet
Background: Accurate verification of nasogastric (NG) tube placement is essential to prevent complications. Although radiography remains the reference standard, repeated imaging is impractical for children receiving home enteral nutrition. Gastric aspirate pH measurement is recommended as the preferred bedside method, but evidence of its diagnostic accuracy in pediatric home care is limited. Methods: This observational diagnostic accuracy study included 40 children receiving home enteral nutrition via NG tubes. Gastric aspirate pH was measured once immediately before a fluoroscopic swallowing assessment scheduled as part of routine care. Standardized pH indicator strips were used, and fluoroscopic findings served as the reference standard. Receiver operating characteristic (ROC) analysis was performed to identify a sample-derived optimal pH cutoff. Results: Fluoroscopy confirmed gastric placement in 27 children (67.5%) and nongastric placement in 13 (32.5%), including high and duodenal tube positions. Gastric pH values were lower than those in nongastric placements (P < 0.001). ROC analysis identified a sample-derived cutoff of 5.65. At the prespecified internationally recommended clinical threshold of ≤5.5, pH measurement correctly classified all tube locations in this cohort. Caregiver verification practices varied considerably, and many used methods not recommended as stand-alone techniques. Conclusions: Gastric aspirate pH measurement showed high diagnostic accuracy for verifying NG tube placement in children receiving home enteral nutrition. Standardized pH testing may offer an inexpensive, practical component of multimethod tube-position assessment. Larger multicenter studies are needed before these findings can be generalized to routine practice. These findings may inform caregiver education and development of standardized pediatric home-care verification protocols.