生物医学文献讨论 PPT课件.pptx
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aspirates
3.discussion
• disadvantages
– do not distinguish between proton-pomp inhibitors (PPIs) and H2 receptor antagonists
– measurement of the insertion-length of the tube is not always right.
• The auscultatory method is unreliable.
Thank you!
• Objective
– test the reliability of pH measurement and the auscultatory method against radiological verifi-cation.
– test the feasibility (practicability) of the bedside pHmeasurement.
– An abdominal X-ray :golden standard ;limitations – The auscultation method – pH measurement :distinguish gastric placement (pH
usually range from 1 to 5) from respiratory, pleural or intestinal placement (pH usually 6 or higher ;limitations
– fasting state :In fasting patients, 78.7% (n = 63) of pH measurements was 5.5 as opposed to 76.6% (n = 102) in patients without fasting.
2.result
• auscultation method :sensitivity 79% and specificity 61%.
4.conclusion
• A pH of 5.5 from tube aspirate is adequate to check the position of the tube in the stomach.
•பைடு நூலகம்Additional measures improve the success to obtain an aspirate from the tube.
• pH measurements :sensitivity 78.4% and specificity 84.6%.
3.discussion
• advantages
– the first large scale study – limit as much as possible placement bias – interobserver variability in the auscultation and/or pH method – by the same experienced advanced practice nurse. – several measures were tested to increase the number of
• The factors changing PH
– taking antacids :Without the use of antacids the average pH was found to be 3.5 (SD: 1.8), with use of antacids the average was 4.6 (SD: 1.7) (p < 0.05).
生物医学文献讨论汇报
Reliability of pH measurement and the auscultatory method to confirm the position of a nasogastric tube
1.introduction
• patients are not or not sufficiently able to swallow. • Nasogastric (NG) intubation
• Recomment
– The NPSA and a National Dutch guideline:a pH between 1 and 5.5 to confirm correct gastric positioning of the tube.
– American Association of Critical Care Nurses :an X-ray every time a new tube is inserted prior to the administration of feeds, medications or fluids.
• blind intubation:relatively harmless and safe • incorrect positioning:even lethal consequences
• How to determine correct positioning of the nasogastric tube ?
3.discussion
• disadvantages
– do not distinguish between proton-pomp inhibitors (PPIs) and H2 receptor antagonists
– measurement of the insertion-length of the tube is not always right.
• The auscultatory method is unreliable.
Thank you!
• Objective
– test the reliability of pH measurement and the auscultatory method against radiological verifi-cation.
– test the feasibility (practicability) of the bedside pHmeasurement.
– An abdominal X-ray :golden standard ;limitations – The auscultation method – pH measurement :distinguish gastric placement (pH
usually range from 1 to 5) from respiratory, pleural or intestinal placement (pH usually 6 or higher ;limitations
– fasting state :In fasting patients, 78.7% (n = 63) of pH measurements was 5.5 as opposed to 76.6% (n = 102) in patients without fasting.
2.result
• auscultation method :sensitivity 79% and specificity 61%.
4.conclusion
• A pH of 5.5 from tube aspirate is adequate to check the position of the tube in the stomach.
•பைடு நூலகம்Additional measures improve the success to obtain an aspirate from the tube.
• pH measurements :sensitivity 78.4% and specificity 84.6%.
3.discussion
• advantages
– the first large scale study – limit as much as possible placement bias – interobserver variability in the auscultation and/or pH method – by the same experienced advanced practice nurse. – several measures were tested to increase the number of
• The factors changing PH
– taking antacids :Without the use of antacids the average pH was found to be 3.5 (SD: 1.8), with use of antacids the average was 4.6 (SD: 1.7) (p < 0.05).
生物医学文献讨论汇报
Reliability of pH measurement and the auscultatory method to confirm the position of a nasogastric tube
1.introduction
• patients are not or not sufficiently able to swallow. • Nasogastric (NG) intubation
• Recomment
– The NPSA and a National Dutch guideline:a pH between 1 and 5.5 to confirm correct gastric positioning of the tube.
– American Association of Critical Care Nurses :an X-ray every time a new tube is inserted prior to the administration of feeds, medications or fluids.
• blind intubation:relatively harmless and safe • incorrect positioning:even lethal consequences
• How to determine correct positioning of the nasogastric tube ?