Predictive criteria for length of nasogastric tube insertion for tube feeding.

This study was aimed at identifying non-invasive techniques and criteria for predicting the proper length for insertion of a nasogastric tube for tube feeding so that the tube tip would be located in the fundus or body for the stomach. A review of literature and existing practices revealed unsubstantiated and discrepant methods currently in use and justified the need for this research. The study involved relating several external body measurements to a measurement from the tip of the nose to the lower esophageal sphincter, via the esophagus, in 99 adult cadavers and 5 normal adult volunteers. A variety of analyses including stepwise multiple regression, were used and are presented. A formula is presented and is stated to provide a 91% confidence level of tube tip placement in the stomach between 1 and 10 cm. This is compared to a confidence level of 72% using the traditional nose to ear to xiphoid measurement. The formula is ( (NEX-50cm) /2)) + 50cm where NEX is the distance from the tip of the nose to the earlobe to the xiphoid. Two methods for simple mechanical clinical application are described.