The effectiveness of the diazo reaction in the determination of tip-end position after blind insertion of the nasoenteric tube by ICU nurses: A prospective comparative study
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: This study aimed to investigate the predictive value of the diazo reaction for determining the tip position of blindly inserted nasoenteric tubes in ICU bedridden patients, and to compare its diagnostic accuracy with other common bedside methods. METHODS: This prospective comparative study was conducted in the ICU of a tertiary hospital. A consecutive sample of 438 patients requiring blind nasoenteric tube insertion was enrolled from June 2021 to January 2022. The tip position was pre-determined using the diazo reaction, the auscultation of water sound, the guidewire rebound test, the negative pressure test, assessment of the nature of the digestive fluid, and the pH test. The final confirmation was obtained through X-ray analysis. Diagnostic parameters, including accuracy, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, Youden's index, the Kappa coefficient, and the area under the receiver operating characteristic (ROC) curve (AUC), were calculated and compared. RESULTS: A total of 427 patients completed the diagnostic methods described above. The diazo reaction demonstrated the highest accuracy and Kappa coefficient, with values of 92.3 % and 0.767, respectively. It also exhibited the most significant AUC of 0.879 (confidence interval: 0.829-0.929) and the highest Youden's index of 0.757. The pH test determination method achieved the highest sensitivity and negative result rates, at 97.3 % and 83.0 %, respectively. The process for assessing the nature of digestive fluid yielded the highest values for specificity, positive predictive value, and favorable likelihood ratio, at 83.5 %, 94.9 %, and 5.030, respectively. CONCLUSIONS: The diazo reaction demonstrates excellent diagnostic performance in verifying the tip position of blindly inserted nasoenteric tubes in ICU patients. It offers superior overall accuracy and consistency compared with conventional bedside methods, representing a reliable and patient-friendly strategy for facilitating accurate bedside placement.
Authors: Chun Song, Qing Liu, Lu Zhang, Kun Wen, Yan Li, Xiuling Zhong, Xiaoyun Wang, Li Li
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7128508281