A simple aspiration test to determine the accuracy of oesophageal placement of fine-bore feeding tubes.

Objective: To evaluate whether a simple aspiration test can be used to accurately confirm the correct placement of fine-bore feeding tubes in the oesophagus and prevent their inadvertent placement in the bronchial tree.

Design: We conducted an ethically approved, randomised, blinded trial to assess the accuracy of a simple aspiration test to differentiate between oesophageal and tracheal placement.

Setting: A tertiary referral cardiothoracic surgical unit.

Patients And Participants: Twenty patients under-going elective cardiac surgery.

Intervention: Once anesthetised, a fine-bore feeding tube was inserted into the oesophagus or trachea and a researcher, blinded to the position, then performed the test. This involved attempted aspiration of > or =10 ml of air before and after insufflation of 10 ml of air and comparison with capnography, a test that has been shown to be highly sensitive and specific.

Measurements And Results: With this small number of patients, the test accurately differentiated between ten oesophageal and ten tracheal placements.

Conclusions: A simple aspiration test could be a useful adjunct to prevent inadvertent bronchial placement of fine-bore feeding tubes. Careful attention must be paid to the technique to ensure that no false positives occur.