{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:31:06Z","timestamp":1787761866472,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Auscultation to verify Ryle\u2019s tube position is difficult in obese patients. We compared the usefulness of ultrasonography (USG) versus auscultation in confirming the correct Ryle\u2019s tube placement in normal versus overweight or obese patients, time taken for confirmation, and incidence of reinsertion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>\n                      A prospective, observational study was carried out on 80 patients. Patients with a body mass index (BMI)&gt;25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      formed group O and those with BMI &lt;25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      constituted group N. After Ryle\u2019s tube insertion correct placement was first confirmed by auscultation. The presence of a gurgling sound over the epigastrium was graded (definite\/doubtful\/absent). During USG evaluation, if Ryle\u2019s tube was not visualized at the subxiphoid region, 20mL of air was injected, looking for dynamic fogging in the stomach. If auscultation yielded doubtful or absent results and USG also failed to confirm, Ryle\u2019s tube was repositioned and confirmed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Group O had a significantly higher BMI. Auscultation time and the time taken for USG confirmation were significantly longer in group O. The percentage of patients with definite auscultatory signs was significantly higher in group N. Significantly higher number of patients in group O had doubtful\/absent auscultatory signs. Ryle\u2019s tube and fogging visualization with USG and the requirement of reinsertion were comparable in both groups. The percentage of patients with definite auscultatory confirmation and definite USG confirmation were comparable in group N. However, in group O, significantly lesser patients had definite auscultatory confirmation compared to definite USG signs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Confirmation of the correct placement of Ryle\u2019s tube using ultrasound is easier than auscultation in overweight and obese patients. In normal patients, both techniques are equally useful.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_237_22","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T22:01:03Z","timestamp":1683842463000},"page":"637-641","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Usefulness of ultrasound in confirming the correct placement of Ryle\u2019s tube compared to the traditional method of auscultation in normal versus overweight and obese patients"],"prefix":"10.4103","volume":"39","author":[{"given":"Sunil","family":"Rajan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niranjan Kumar","family":"Sasikumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"Sudevan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pulak","family":"Tosh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"R1-20240828","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/MOG.0b013e3280287a0f","article-title":"Complications related to feeding tube placement","volume":"23","author":"Metheny","year":"2007","journal-title":"Curr Opin Gastroenterol"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.annemergmed.2006.10.016","article-title":"Capnography for Procedural Sedation and Analgesia in the Emergency Department","volume":"50","author":"Krauss","year":"2007","journal-title":"Ann Emerg Med"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/j.1365-2702.2010.03191.x","article-title":"Effectiveness of the auscultatory and pH methods in predicting feeding tube 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neonate","volume":"13","author":"Atalay","year":"2019","journal-title":"Saudi J Anaesth"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/1757-7241-20-38","article-title":"The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center","volume":"20","author":"Kim","year":"2012","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"R11-20240828","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1186\/s13054-020-03285-8","article-title":"Rapid positioning of nasogastric tube byultrasound in COVID-19 patients","volume":"24","author":"Qian","year":"2020","journal-title":"Critical Care"}],"container-title":["Journal of Anaesthesiology Clinical 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