• Suzanne M Burns, Richard Carpenter, Cheri Blevins, Sharon Bragg, Mary Marshall, Liz Browne, Martha Perkins, Rebecca Bagby, Kris Blackstone, and Jonathon D Truwit.
• School of Nursing, University of Virginia Health System, Charlottesville, VA, USA.
• Am. J. Crit. Care. 2006 Mar 1; 15 (2): 188-95.

BackgroundIn the medical intensive care unit at the University of Virginia Health System, capnography is used to detect end-tidal carbon dioxide to protect patients from inadvertent airway cannulation during placement of gastric tubes.ObjectivesTo compare the method in which capnography is used with a method in which a colorimetric carbon dioxide detector is used and to determine what variables affect accurate placement of gastric tubes.MethodsA prospective convenience sample of 195 gastric tube insertions was studied in 130 adult patients in a medical intensive care unit. Standard insertions of gastric tubes (done with capnography) were simultaneously monitored by using a disposable colorimetric device, with a color change indicating the presence of carbon dioxide.ResultsInsertion variables included tube type (60% Salem sump tubes, 40% soft-bore feeding tubes), route of insertion (71% oral, 29% nasal), mechanical ventilation (81%), and decreased mental status (72%). Carbon dioxide was successfully detected with the colorimetric indicator (within seconds) in all insertions in which carbon dioxide was detected by capnography. When carbon dioxide was detected (27% of insertions), the tubes were withdrawn and reinserted. Carbon dioxide detection during tube placement was significantly associated with nasal insertions (P = .03) and spontaneously breathing/nonintubated status (P = .01) but not with mental status or tube type.ConclusionsA colorimetric device is as accurate as capnography for detecting carbon dioxide during placement of gastric tubes.

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