Randomized Clinical Trial Comparing Two Methods of Measuring Insertion Length of Nasogastric Tubes in Newborns

The selection of a method for measuring the insertion length of nasogastric tubes in newborns is an important factor in establishing the safe use of this device.

The objective was to verify whether there is a difference in the proportion of correctly placed nasogastric tubes when using the nose, earlobe, mid-umbilicus (NEMU) method and the weight-based equation for measuring the insertion length.

This study is a randomized, controlled, blinded study comparing 2 methods of nasogastric insertion at a neonatal unit, with intensive and intermediate care, on 162 randomized individuals. Radiological assessment and pH test were conducted to verify tube placement. Data were collected on sex, birth weight, gestational age, and days of life. A log-binomial model was used to verify whether there were placement differences between investigated methods.

Of the patients, 56.1% were male, who had a mean birth weight of 1886.8 g and gestational age of 32.9 weeks and were 10.8 days old. Radiological images demonstrated that tubes were properly placed in the gastric body in 67.5% of patients using the NEMU method and in 91.5% using the weight-based equation: the weight-based equation was superior to the NEMU method, with a prevalence ratio of 1.36 (95% CI, 1.15-1.44). There was no difference between the 2 methods, according to pH test (P-value: .7179).

Based on radiographic confirmation, the weight-based equation for measuring the insertion length of the nasogastric tube in newborns resulted in significantly more nasogastric tubes being placed in the correct intragastric location.