{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:51Z","timestamp":1789715031025,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017712","name":"Bureau of Science and Technology of Ganzhou Municipality","doi-asserted-by":"publisher","award":["GZ2021ZSF102"],"award-info":[{"award-number":["GZ2021ZSF102"]}],"id":[{"id":"10.13039\/100017712","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postpyloric nasoenteric feeding reduces feeding intolerance and is recommended for critically ill patients. However, reliable confirmation of tip location remains challenging. Although radiography is the pre\u2010feeding gold standard, repeated use of radiography during insertion is impractical in resource\u2010limited intensive care units (ICUs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the accuracy of five bedside methods for preliminary nasoenteric tube tip localization against radiography. Secondary objectives included safety assessment and determining the optimal cut\u2010off for pH difference in aspirate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This prospective, blinded diagnostic accuracy study was conducted in a tertiary ICU following the STARD 2015 guidelines, using a two\u2010stage assessment procedure: initial gastric verification followed by postpyloric advancement. All participants underwent five index tests performed by a trained senior nurse: pH difference in aspirate (comparing gastric and post\u2010advancement aspirate), pH testing of aspirate, auscultation of bubbling sounds, palpation for bubbling sounds and ultrasonographic gastric antrum assessment. Abdominal radiography served as the reference standard. The area under the curve (AUC) was calculated for each test with pairwise comparisons. Adverse events were monitored within 24\u2009h. The optimal pH difference in aspirate cut\u2010off was determined using Youden's index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between October 2021 and January 2022, 60 patients were enrolled; postpyloric placement was confirmed in 47 (78.3%). Palpation for bubbling sounds (AUC 0.902), ultrasonographic gastric antrum assessment (AUC 0.863) and pH difference in aspirate (cut\u2010off \u2265\u20091, AUC 0.808) demonstrated superior accuracy compared with auscultation (AUC 0.622) and pH testing of aspirate (AUC 0.586) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The optimal pH difference in aspirate cut\u2010off was \u2265\u20091, yielding 100% sensitivity. No adverse events occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Palpation for bubbling sounds, ultrasonographic gastric antrum assessment and pH difference in aspirate are accurate bedside methods that can guide nurse\u2010led nasoenteric tube placement, reduce interim radiographs and reserve mandatory confirmation for pre\u2010feeding safety checks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>This study validates three accurate bedside methods\u2014pH difference in aspirate, palpation for bubbling sounds and ultrasonographic gastric antrum assessment\u2014that can be integrated into nurse\u2010led protocols to guide nasoenteric tube placement in resource\u2010limited ICUs, reducing reliance on interim radiographs while maintaining patient safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70503","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T08:54:51Z","timestamp":1776761691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Accuracy of Bedside Methods for Preliminary Nasoenteric Tube Tip Localization in Intensive Care: A Prospective Diagnostic Study"],"prefix":"10.1111","volume":"31","author":[{"given":"Qianhui","family":"Yu","sequence":"first","affiliation":[{"name":"The First Clinical Medical College of Gannan Medical University  Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8604-1345","authenticated-orcid":false,"given":"Yanmei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine First Affiliated Hospital of Gannan Medical University  Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine First Affiliated Hospital of Gannan Medical University  Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfang","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine First Affiliated Hospital of Gannan Medical University  Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingbang","family":"Zhong","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College of Gannan Medical University  Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueling","family":"He","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College of Gannan Medical University  Ganzhou 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