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 ≥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.