Development of a reliable and valid bedside test for bilirubin and its utility for improving prediction of feeding tube location.
Development of a reliable and valid bedside test for bilirubin and its utility for improving prediction of feeding tube location.
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开发可靠有效的胆红素床边测试及其用于改进饲管位置预测的实用性。
DOI：
10.1097/00006199-200011000-00002
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发表时间：
2000
期刊：
影响因子：
2.5
通讯作者：
Stewart,BJ
中科院分区：
文献类型：
--
作者：
Metheny,NA;Smith,L;Stewart,BJ
背景：在仅基于pH值的算法中加入实验室胆红素读数可以改善饲管位置的预测；虽然有可靠的ph试纸，但没有床边测试来测量饲管吸入物中的胆红素。目的：本研究的目的是测试新开发的刻度胆红素试纸在测量饲管吸入物中胆红素含量的有效性，并确定pH值和胆红素试纸读数结合预测饲管位置的有效性。方法：对新插入饲管（鼻胃管328例，鼻肠管303例）的成人急症患者，在x线片确定饲管位置后5分钟内，采集631例胃肠道标本，同时进行pH和胆红素检测。此外，还检测了225份呼吸道样本。胆红素的测量与测试条结合新开发的比色目视胆红素（VBIL）规模，并通过实验室分析。用试纸和pH计测量pH值。研究助理和护理人员读取胆红素和pH值测试结果，并与x线摄影确定的管位置进行比较。结果：5点VBIL量表读数与修剪实验室胆红素的相关性为0.93，二分类读数相关性为0.87，kappa等于0.86。如果pH值大于5，胆红素小于5 mg/dL， 225例呼吸道病例100%被确诊。在pH≤5、胆红素≤5 mg/dL的病例中，98%为胃病例。在pH大于5和胆红素大于5 mg/dL类别中，近88%的病例为肠道病例。结论：新研制的VBIL量表是测定饲管吸入物中胆红素含量的有效方法。此外，与仅通过ph试纸预测导管位置相比，VBIL量表/胆红素试纸与ph试纸联合使用的二分读数提高了区分呼吸管和胃肠道管放置以及胃管和肠管放置的能力。指出了对VBIL尺度的改进，以提高其准确性。
Background:The addition of laboratory bilirubin readings to an algorithm based on pH alone improves prediction of feeding tube location; although reliable pH-teststrips are available, there is no bedside test to measure bilirubin in feeding tube aspirates.Objectives:This study was designed to test the efficacy of a bilirubin teststrip with a newly developed scale in measuring the bilirubin content in feeding tube aspirates, and to determine the effectiveness of a combination of readings from pH and bilirubin teststrips in predicting feeding tube location.Methods:A total of 631 gastrointestinal specimens for concurrent pH and bilirubin testing were obtained from adult, acutely ill patients with newly inserted feeding tubes (nasogastric, n= 328; nasointestinal, n= 303) within 5 minutes of radiographs taken to determine tube location. In addition, 225 respiratory specimens were tested. Bilirubin was measured with a teststrip incorporating a newly developed colorimetric visual bilirubin (VBIL) scale, and by a laboratory assay. pH was measured with a teststrip and a pH-meter. Results from the bilirubin and pH tests were read by research assistants and staff nurses and compared with tube location as determined by radiography.Results:The correlation between readings made from the 5-point VBIL scale and the trimmed laboratory bilirubin was 0.93, with dichotomized readings correlating 0.87 and kappa equal to 0.86. A pH greater than 5 and a bilirubin less than 5 mg/dL successfully identified 100% of the 225 respiratory cases. In the category of pH 5 or less and bilirubin less than 5 mg/dL, 98% of the cases were gastric cases. In the category of pH greater than 5 and bilirubin 5 or higher mg/dL, nearly 88% of the cases were intestinal cases.Conclusions:The newly developed VBIL scale is effective in determining the bilirubin content in feeding tube aspirates. Furthermore, compared with predicting tube location from pH-paper alone, dichotomized readings from the VBIL scale/bilirubin teststrip used in combination with a pH-teststrip improved the ability to differentiate between respiratory and gastrointestinal tube placement, as well as between gastric and intestinal tube placement. Refinement of the VBIL scale is indicated to increase its accuracy.
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DOI：
--
发表时间：
1967
期刊：
Zeitschrift fur klinische Chemie und klinische Biochemie
影响因子：
--
作者：
K. Kramer
通讯作者：
K. Kramer
带饲管的鼻肺插管：病例报告和文献综述。
DOI：
--
发表时间：
1985
期刊：
JPEN - Journal of Parenteral and Enteral Nutrition
影响因子：
--
作者：
T. Lipman;T. Kessler;A. Arabian
通讯作者：
A. Arabian
影响因子：
9
作者：
G. Schorlemmer;J. Battaglini
通讯作者：
J. Battaglini
右侧胸膜腔经支气管插管：聚氯乙烯管鼻胃插管的罕见并发症——案例研究。
DOI：
--
发表时间：
1993
期刊：
Heart & lung : the journal of critical care
影响因子：
--
作者：
A. el;D. C. Watson
通讯作者：
D. C. Watson
pH 测量在预测饲管放置方面的有效性：更新
影响因子：
2.5
作者：
N. Metheny;L. Reed;L. Wiersema;M. McSweeney;M. A. Wehrle;Joan Clark
通讯作者：
Joan Clark