1306 Use of ester impregnated pH strips in identification of gastric placement of feeding tubes in neonates: a diagnostic accuracy and professionals’ perception study
Year: 2021
Type: conference-abstract
Abstract: Background Naso or oro-gastric feeding tubes are essential component of care in providing nutrition and medication in neonatal units. The existing standard pH strips lack sensitivity. As a result, neonates may require re-insertion or some cases require unnecessary x-rays. A new generation of ester impregnated pH strips have been developed, utilising human pre-duodenal gastric lipase (HGL), which is only present in the stomach, to improve sensitivity of the test strips to gastric placements. Objectives 1) to assess the sensitivity of the novel ester impregnated pH test strip compared to the standard pH strips. 2) to assess healthcare professionals’ perception of the standard pH test strips and the ester-impregnated pH strips. Methods We carried out a prospective observational diagnostic accuracy study at the neonatal units of two NHS hospitals comparing the ester-impregnated strips to the standard pH strips. The primary end point is the sensitivity of the pH tests at the recommended pH cut-off of 5.5. We also carried out an online survey with healthcare professionals involved in the study to qualitatively assess through validated scales their perceived usability, trust and acceptance of the standard pH test strips and the general perception of the HGL, enhanced pH test strip. The study was funded by NIHR Innovate UK, received research ethics approval from HRA (REC ref: 19/LO/1726) and was registered in the clinicaltrials.gov website (NCT04271995). Results A total of 233 samples were collected from 141 infants with the median gestation age of 32 weeks (range 23–41 weeks). The sensitivities of the standard and novel pH tests were respectively 82.0% (95% CI: 77.0%-86.9%) and 90.1% (95% CI: 86.3%-94.0%) under pH cut-off of 5.5. Term babies had significantly lower pH compared to pre-term babies (mean pH: 3.7 versus 4.3, p=0.03). Aspirates from neonates fed by mother or donor expressed milk had significantly lower pH compared to neonates fed by formula milk (mean pH: 4.01 versus 4.78, p<0.001). A total of 17 health care professionals completed the online survey, which reported a high level of perceived usability for the standard pH test strips (82.20%). As well as a positive level of trust (82.16%), acceptance (84.87%) and a low level of anxiety in use (7.84%). Also, the intention to use the HGL enhanced pH test strip was reported as 84.03%. Conclusions The novel ester impregnated pH strips can detect gastric placements of feeding tubes in neonates with high level of accuracy and are acceptable by the healthcare professionals involved in neonatal care.
Source: Abstracts
Authors: Anna McLister, Jayanta Banerjee, Batia Gourin, Kirupalani Mariampillai, Zoe McClure, Robert Boyle, George Hanna, Melody Ni
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3202588392