Bedside Ultrasonography-Guided Nasogastric Tube Placement: Scoping Review

Area of Science:

• Medical Imaging
• Gastroenterology
• Critical Care Medicine

Background:

• Accurate nasogastric tube (NGT) placement is crucial for patient safety and effective treatment.
• Traditional methods for NGT confirmation carry risks, such as radiation exposure.
• Bedside ultrasonography is emerging as a potential alternative for NGT placement verification.

Purpose of the Study:

• To conduct a scoping review of existing evidence on the use of bedside ultrasonography for confirming short-term nasogastric tube (NGT) placement in adults.
• To synthesize findings regarding the feasibility, accuracy, and limitations of ultrasonography for this indication.

Main Methods:

• A comprehensive literature search was performed across multiple databases (CINAHL, Embase, LILACS, PubMed, Scopus) and gray literature.
• Included studies and clinical guidelines focused on bedside ultrasonography for short-term NGT placement in adult patients.
• Data were extracted and narratively summarized using the I-AIM framework.

Main Results:

• Twenty-nine studies met the inclusion criteria, predominantly single-center observational studies in intensive care and emergency settings.
• Ultrasound was mainly used for pre-enteral nutrition confirmation, with varied acquisition protocols and anatomical landmarks.
• Facilitators included bedside feasibility and no radiation; barriers included operator dependency and visualization issues.

Conclusions:

• Ultrasonography appears to be a feasible and radiation-free bedside method for confirming NGT placement.
• With structured training, healthcare professionals may achieve diagnostic accuracy in certain settings.
• Further robust multicenter studies are required to confirm these findings and guide clinical implementation.