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Saudi J Anaesth. 2019 Jan-Mar;13(1):23-27. doi: 10.4103/sja.SJA_413_18.

Bedside ultrasonography for the confirmation of gastric tube placement in the neonate.

Author information

Department of Anesthesiology, Istanbul Medipol University, International School of Medicine, Istanbul, Turkey.
Department of Radiology, Ondokuz Mayis University, Samsun, Turkey.
Division of Neonatology, Department of Pediatrics, Ondokuz Mayis University, Samsun, Turkey.
Department of Biostatistics and Medical Informatics, Ondokuz Mayis University, Samsun, Turkey.
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.



Naso/Orogastric tube (NOGT) misplacement can lead to significant complications. Therefore, the assessment of tube position is essential to ensure patient safety. Although radiography is considered the gold standard for determining NOGT location, new methods may be helpful in reducing repetitive radiation exposure, especially for neonates. In this study, we sought to investigate if bedside ultrasonography (BUSG) can be used to verify NOGT placement in neonatal intensive care patients.

Materials and Methods:

Infants requiring NOGT placement were enrolled. After insertion of the NOGT, the location was first identified using BUSG and then confirmed using abdominal radiography for comparison.


The study cohort included 51 infants with an average gestational age of 34 ± 4.9 weeks. BUSG determined the NOGT location correctly with a sensitivity of 92.2%. The location of the NOGT could not be determined by BUSG in four neonates (7.8%). In one infant, the NOGT was positioned in the esophagus, as determined both by BUSG and radiography.


BUSG is a promising diagnostic tool for determining NOGT location in neonates, thereby eliminating the need for abdominal radiography.


Enteral nutrition; infant; intensive care units; nasogastric tube; ultrasonography

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