Diagnostic accuracy of POC enzymatic test for NG tube placement.

  • Research type

    Research Study

  • Full title

    A diagnostic accuracy study to evaluate a point-of-care lipase/pH test strip to confirm correct nasogastric tube position.

  • IRAS ID

    192968

  • Contact name

    George Hanna

  • Contact email

    g.hanna@imperial.ac.uk

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    0 years, 8 months, 1 days

  • Research summary

    At least 1 million nasogastric (NG) tubes are used in the UK each year, often for supplementary feeding. They allow liquid feed to be passed directly into the stomach without requiring the patient to swallow. The National Patient Safety Agency issued guidelines recommending aspirate pH is tested before every feed and at least once every day to check nasogastric tube position and prevent harm from feeding into the lungs through a misplaced nasogastric tube. Current best practice uses pH testing to ensure the tube is correctly positioned in the stomach. However, up to 42% of hospital inpatients receive antacid medications that render the results of pH test paper falsely negative.
    The ideal solution would be a test that was accurate despite non-acidic gastric aspirates, safe, point-of-care, and non-ionising. One barrier to a single reagent test is that human gastric lipase is inactivated by acidic stomach contents and therefore is unsuitable as a means of determining nasogastric tube position on its own. It has been suggested that a combined test for pH incorporating a gastric enzyme may be significantly more accurate than each in isolation. The objective of this study is to determine the accuracy of a novel nasogastric tube position test that was compatible with non-acidic gastric aspirates by utilising human gastric lipase to lower the pH of gastric aspirates on pH test paper. This will be carried out by comparing the new test to the standard pH paper that is currently used. In addition a human factors workshop with interested stakeholders will be undertaken to assess the usability and stakeholder attitudes towards the new test.

  • REC name

    East of England - Cambridge East Research Ethics Committee

  • REC reference

    16/EE/0144

  • Date of REC Opinion

    8 Apr 2016

  • REC opinion

    Unfavourable Opinion