Does the use of an enteral feeding tube with a pH-sensitive tip facilitate enteral nutrition?
Enteral feedings are often used to achieve adequate, cost-effective nutritional support. Placement of feeding tubes is accomplished by either a trained nurse or physician form a nutritional support team. A radiographic examination is required to confirm proper placement. These examinations are expensive and delay initiation of feeding while radiographs are taken and evaluated. A new enteral feeding tube (pH-FT) that incorporates a permanent pH-sensitive tip into a small-bore feeding tube has been developed. A detachable meter is used to monitor pH. This study was undertaken to determine if the pH-FT was reliable in determining placement as compared with radiograph interpretation. Twenty inpatients (14 males and six females) with diagnoses including major burn, trauma, and gastrointestinal disease were intubated with the use of pH-FT. Measurement of pH was taken at the time the radiographic examination was done. Reference pHs used include the following: stomach, 1.1 to 2.0; stomach in the presence of antacids/H2 blockers, 3.5 to 5.0; and the duodenal, 6.0 to 7.3. Of the 20 patients studied, there were four in whom the pH assessment indicated stomach placement with 100% radiograph confirmation. Sixteen patients had duodenal placement indicated by pH assessment, with radiograph confirmation in 88% (14) of the patients. Two patients had a pH indicating duodenal placement, and radiographic examination showed placement to the pH-FT in the stomach. Two benefits of the pH-FT would be decreased cost and earlier initiation of enteral feeding when the radiographic examination and interpretation are eliminated.