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Updated: Aug 8, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Effectiveness of pH measurements in predicting feeding tube placement: an update
N Metheny1, L Reed, L Wiersema
1St. Louis University School of Nursing, MO.
Insights
pH testing of feeding tube aspirates accurately distinguishes gastric from intestinal placement. This method aids in confirming correct nasogastric tube positioning and preventing complications.
Area of Science:
- Clinical Medicine
- Gastroenterology
- Medical Devices
Background:
- Accurate feeding tube placement is critical for patient safety and effective nutrition delivery.
- Differentiating between gastric, intestinal, and respiratory placement can be challenging.
- Current methods for confirmation may have limitations.
Purpose of the Study:
- To evaluate the efficacy of pH testing of aspirates for determining feeding tube placement.
- To differentiate between gastric and intestinal tube placement.
- To distinguish gastric tube placement from inadvertent respiratory tract placement.
Main Methods:
- A clinical study involving 605 subjects with feeding tubes.
- Collection and pH measurement of 794 aspirates from nasogastric and nasointestinal tubes.
- Concurrent confirmation of tube position using X-rays.
Main Results:
- pH values reliably differentiated gastric from intestinal feeding tube placement (p < .0001).
- Gastric aspirates (85%) showed pH 0-6.0; intestinal aspirates (87%) showed pH > 6.0.
- Four cases of respiratory tract placement had pH values > 6.5.
Conclusions:
- pH testing of feeding tube aspirates is a valuable, non-invasive tool for confirming placement.
- This method enhances the safety and accuracy of feeding tube utilization.
- pH monitoring can help prevent potentially serious complications associated with malpositioned tubes.
Abstract:
This paper reports further findings from an ongoing clinical study designed to evaluate the extent to which pH values of aspirates from feeding tubes can be used to differentiate between gastric and intestinal tube placement and gastric and respiratory tube placement. The sample consisted of 405 aspirates from small-bore nasogastric tubes and 389 aspirates from nasointestinal tubes, which were obtained from 605 subjects ranging in age from 18 to 94 years. Data were collected at the time of initial placement and again, when possible, after feedings were initiated. A total of 794 pH-meter readings were made concurrently with X-rays to determine feeding tube position. Gastric placement was successfully distinguished from intestinal placement of the feeding tubes on the basis of pH-meter readings (p < .0001). Approximately 85% of the 405 pH-meter readings from gastric fluid were between 0 and 6.0, while over 87% of the 389 pH-meter measurements performed on intestinal aspirates were greater than 6.0. Four aspirates from feeding tubes inadvertently placed in the respiratory tract (two in the pleural space and two in the tracheobronchial tree) were tested with a pH-meter, all had pH values greater than 6.5.
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