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Noninvasive Verification of Nasogastric Tube Placement Using a Magnet-Tracking System: A Pilot Study in Healthy Subjects

Premysl Bercik, MD^*, Vincent Schlageter, PhD, Marina Mauro, MD^*, John Rawlinson, MD, Pavel Kucera, MD and David Armstrong, MD^*

From the ^* Division of Gastroenterology and Intestinal Disease Research Program, and the Department of Diagnostic Imaging, McMaster University, Hamilton, Canada; and the Institute of Physiology, University of Lausanne, Lausanne, Switzerland

Correspondence: David Armstrong, HSC-4W8, Division of Gastroenterology, McMaster University Medical Centre, 1200 Main St. W, Hamilton, Ontario L8N 3Z5, Canada. Electronic mail may be sent to armstro{at}mcmaster.ca.

Background: Fluoroscopic verification of nasogastric (NG) feeding tube placement is inconvenient and involves radiation exposure. We tested whether the position of an NG tube can be assessed reliably by a recently introduced magnet-tracking system. Methods: A small permanent magnet was attached at the end of an NG tube and its position was monitored using an external sensor array connected to a computer. NG tube trajectory, spontaneous movements of the magnet, and its position relative to the lower esophageal sphincter (LES) and xiphisternum were assessed in 22 healthy subjects and compared with esophageal manometry. In 12 subjects, localization of the magnet was also compared with fluoroscopy. Results: Magnet-tracking displayed NG tube tip movement reproducibly as it moved vertically in the esophagus and then laterally into the stomach. Compared with manometry, the accuracy and sensitivity of magnet tracking for localization of the NG tube tip, above or below the diaphragm, were 100%. Compared with fluoroscopy, the accuracy of NG tube localization by magnet tracking was 100%. With the magnet in the stomach, but not in the esophagus or LES, low amplitude displacements at a frequency of 3 per minute, consistent with gastric slow wave activity, were observed. Conclusions: Magnet tracking allows accurate, real-time, 3-dimensional localization of an NG tube with respect to anatomic landmarks. Recorded motor patterns are indicative of the position of the NG tube. Magnet tracking may be a useful tool for bedside placement of nasogastric and enteral feeding tubes.

Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 4, 305-310 (2005)
DOI: 10.1177/0148607105029004305


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