Imperial College London
Alternate

Dr Melody Zhifang Ni

Faculty of Medicine, Department of Surgery & Cancer

Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 3312 7657z.ni

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ni:2021:10.1186/s41512-021-00111-9,
author = {Ni, M and Adam, ME and Akbar, F and Huddy, JR and Borsci, S and Buckle, P and Rubulotta, F and Carr, R and Fotheringham, I and Wilson, C and Tsang, M and Harding, S and White, N and Hanna, GB},
doi = {10.1186/s41512-021-00111-9},
journal = {Diagnostic and Prognostic Research},
pages = {1--10},
title = {Development and validation of ester impregnated pH strips for locating nasogastric feeding tubes in the stomach-a multicentre prospective diagnostic performance study.},
url = {http://dx.doi.org/10.1186/s41512-021-00111-9},
volume = {5},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: NG (nasogastric) tubes are used worldwide as a means to provide enteral nutrition. Testing the pH of tube aspirates prior to feeding is commonly used to verify tube location before feeding or medication. A pH at or lower than 5.5 was taken as evidence for stomach intubation. However, the existing standard pH strips lack sensitivity, especially in patients receiving feeding and antacids medication. We developed and validated a first-generation ester-impregnated pH strip test to improve the accuracy towards gastric placements in adult population receiving routine NG-tube feeding. The sensitivity was improved by its augmentation with the action of human gastric lipase (HGL), an enzyme specific to the stomach. METHODS: We carried out a multi-centred, prospective, two-gate diagnostic accuracy study on patients who require routine NG-tube feeding in 10 NHS hospitals comparing the sensitivity of the novel pH strip to the standard pH test, using either chest X-rays or, in its absence, clinical observation of the absence of adverse events as the reference standard. We also tested the novel pH strips in lung aspirates from patients undergoing oesophageal cancer surgeries using visual inspection as the reference standard. We simulated health economics using a decision analytic model and carried out adoption studies to understand its route to commercialisation. The primary end point is the sensitivity of novel and standard pH tests at the recommended pH cut-off of 5.5. RESULTS: A total of 6400 ester-impregnated pH strips were prepared based on an ISO13485 quality management system. A total of 376 gastric samples were collected from adult patients in 10 NHS hospitals who were receiving routine NG-tube feeding. The sensitivities of the standard and novel pH tests were respectively 49.2% (95% CI 44.154.3%) and 70.2% (95% CI 65.674.8%) under pH cut-off of 5.5 and the novel test has a lung specificity of 89.5% (95% CI 79.6%, 99.4%). Our simulation showed that using the
AU  - Ni,M
AU  - Adam,ME
AU  - Akbar,F
AU  - Huddy,JR
AU  - Borsci,S
AU  - Buckle,P
AU  - Rubulotta,F
AU  - Carr,R
AU  - Fotheringham,I
AU  - Wilson,C
AU  - Tsang,M
AU  - Harding,S
AU  - White,N
AU  - Hanna,GB
DO  - 10.1186/s41512-021-00111-9
EP  - 10
PY  - 2021///
SN  - 2397-7523
SP  - 1
TI  - Development and validation of ester impregnated pH strips for locating nasogastric feeding tubes in the stomach-a multicentre prospective diagnostic performance study.
T2  - Diagnostic and Prognostic Research
UR  - http://dx.doi.org/10.1186/s41512-021-00111-9
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34903303
UR  - https://diagnprognres.biomedcentral.com/articles/10.1186/s41512-021-00111-9
UR  - http://hdl.handle.net/10044/1/93329
VL  - 5
ER  -
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