Nasogastric tube placement

In the presence of an accurate nasogastric tube placement, most studies using nonabsorbable volume markers have reported about a 90% recovery, indicating that an inevitable loss of about 10% of the gastric juice volume occurs through the pylorus. The infusion of nonabsorbable volume markers is used to improve the accuracy of the recovered gastric volumes. Table 1 summarizes marker substances that have been used and those that have potential for human use and their methods of estimation. Of these markers, poly(ethylene glycol) (PEG) has been the most widely used. However, the methods used for its estimation are still laborious, nonspecific, insensitive, and are associated with analytical errors. In addition. 

Application of a Manometric Technique to Verify Nasogastric Tube Placement in... 

Keywords— manometric technique, nasogastric tube placement, mechanically ventilated patients, manometer, accuracy. 

Fig. 2 The manometric technique for verification of nasogastric tube placement (baseline pressure reading 8 cmH20). (A) Air inflation test the intragastric placement of a nasogastric tube shows insignificant changes in pressure (< 2 cm H2O) upon air inflation (arrow). (B) Epigastric palpation test pressure swings during manual compressions of upper abdomen (arrow) are observed when a nasogastric tube is placed in the stomach...

Table 2 The results of manometry and fiberscopy for verification of nasogastric tube placement...

Placement of a nasogastric tube in the appropriate patient o Benefits may include... 

Antiplatelet agents, anticoagulants, and invasive procedures such as the insertion of a central line or the placement of a nasogastric tube should be avoided for 24 hours after the infusion of alteplase to prevent bleeding complications. Bladder catheterization should also be avoided for 30 minutes post-infusion. 

Cooperative patients with intact airway protective reflexes may drink the solution. However, the large volume and taste often limit even the most motivated patient s ability to comply. If the patient is unable or unwilling to drink this solution, it should be administered through a small-bore nasogastric tube after placement is confirmed. Unconscious patients with protected airways may receive WBI. Prewarming the irrigant to a temperature of 37°C avoids the potential complication of hypothermia. The endpoint of WBI is the arrival of clear rectal effluent and/or resolution of toxic effect. 

Abstract— Objectives Confirmation of nasogastric tube (NGT) placement is sometimes difficult in clinical practice, especially in intubated, mecbanically ventilated patients. Tbe purpose of tbis study was to vaUdate tbe accuracy of a manometric tecbniqne on confirmation of intragastiic NGT placement in intubated, mecbanically ventilated patients. 

Placement of a nasogastric tube (NGT) is a common procedure in the intensive care unit and operating room for reasons of gastric decompression, nutrition, and drug administration. However, verification of correct NGT... 

Many critically ill patients have a nasogastric tube in place to manage secretions, prevent gastric distention, or provide nutritional support. Placement of a nasogastric tube may increase nasopharyngeal colonization, cause reflux of gastric contents, and act as a conduit for bacteria to migrate to the oropharynx (see Table 3) (16,128,131,132). 

Nasotracheal intubation and placement of a nasogastric tube are underappreciated risk factors for nosocomial sinusitis and VAP (128,147). The association between the development of sinusitis and VAP is difficult to demonstrate. However, the presence of sinusitis has been shown to be associated with a substantial increase in the number of nosocomial pathogens that are identified in patients with VAP. In a study by Rouby and coworkers, maxillary sinusitis, diagnosed by baseline and serial computer axial tomographic scan and needle... 

Routinely check tube placement remove nasogastric tube promptly when no longer required position HOB up. 

Nasogastric or orogastric Short-term Intact gag reflex Normal gastric emptying Manually at bedside Ease of placement Allows for all methods of administration Inexpensive Multiple commercially available tubes and sizes Potential tube displacement Potential increased aspiration risk... 

Nasogastric or orogastric Short-term Manually at bedside Ease of placement Potential tube displacement... 

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