Effect of a novel gastric tube insertion method using a light-emitting diode source and fiber in neonates: a multicenter study

Objective The placement of nasogastric tube (NGT) or an orogastric tube (OGT) is not always accurate in the stomach because the insertion is blind. Therefore, verifying the tip position of NGT or OGT after the insertion is essential. The aim of the study is to assess whether a light-emitting diode source and fiber (LED-SF) can accurately confirm the tip placement of NGT/OGT in neonates. Study Design This prospective multicenter study was conducted from December 2023 to March 2024, at five tertiary NICUs in Japan. Neonates who required a NGT/OGT were eligible for inclusion. The primary outcome was whether the tip of the NGT/OGT inserted using the LED-SF was in the stomach. The secondary outcome was to compare the length determined by LED-SF light to the final decision length determined after X-ray. A statistical analysis was performed using cross-tabulation tests and linear regression. Results A total of 101 neonates with a corrected gestational age of median 36.1 [range 24.3– 45.7] weeks were enrolled. All of the tube tips were in the stomach (100%). There were no adverse events. The association between the insertion length determined using LED-SF and the final length determined after X-ray was significant (r2 = 0.844, P<0.001). Conclusion LED-SF is an effective and safe method for verifying the tip position of NGT/OGT, and can be easily used by anyone with minimal training. The LED-SF may be a reliable standard for bedside verification of NGT/OGT tip placement in preterm and term neonates.