Clinical Experience With Nasogastric Tube Placement Using a Biologically Transparent Illumination System in Critically Ill Patients

A biologically transparent illumination (BTI) system has been proposed as an adjunctive method for confirming nasogastric tube (NGT) placement by visualizing a light in the stomach. However, its clinical applicability in critically ill patients remains unclear. We conducted a preliminary prospective observational study to evaluate the clinical feasibility and detectability of a BTI system for NGT placement in critically ill patients. Ten critically ill patients underwent NGT placement using a BTI system after admission to the intensive care unit (ICU). The detected BTI light was assessed in the epigastric region, and the NGT tip was subsequently confirmed using X-ray. The BTI light was visible in five patients, while X-ray confirmed stomach placement in all. Notably, in patients with obesity, massive ascites, or a considerable distance between the NGT tip and the skin surface, the BTI system did not detect the light. No complications during the procedure were reported. This early clinical experience indicates that although BTI detectability is limited by patient-specific anatomical factors, the system may serve as a supportive, hypothesis-generating approach for bedside confirmation of NGT placement in critically ill patients. Further studies are needed to identify the patient groups that benefit most from the BTI system.