Category: Gastrointestional
Keywords: NG Tube (PubMed Search)
Posted: 11/9/2023 by Neeraja Murali, DO, MPH
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Think before placing a nasogastric tube!
Multiple articles which discussed complications of NGT placement were included in this integrative review, with the majority (n=67) publishing results in English. The authors categorized adverse events into two broad categories:
1) Mechanical adverse events - including respiratory, esophageal, and pharyngeal complications, obstructed tube, intestinal and intracranial (!) perforation, and tube withdrawal
-The largest cohort (n=44) was respiratory, with displacement or placement of tube to the respiratory tract
2) Others - pressure injury and misconnection
-One study showed pressure related injury in 25%, and 5 articles discussed complications of misconnection (including extravasation of gastric fluids and inadvertent connection to central venous catheters)
16 of the 69 studies reported death as a consequence of improper placement.
One big takeaway: there is no universally accepted standard for verificaiton of tube placement. Xray is considered to be *most* accurate. Tubes should also be checked periodically and depth should be marked. Evidence-based guidelines need to be developed to improve patient safety, outcomes, and quality of care.
Motta APG, Rigobello MCG, Silveira RCCP, Gimenes FRE. Nasogastric/nasoenteric tube-related adverse events: an integrative review. Rev Lat Am Enfermagem. 2021 Jan 8;29:e3400. doi: 10.1590/1518-8345.3355.3400. PMID: 33439952; PMCID: PMC7798396.