Nasogastric tubes are used to deliver substances to or drain substances from the stomach. They are commonly used to treat bowel obstructions by decompressing the stomach, administer medications, provide enteral nutrition, or perform stomach lavage. Placement should be confirmed with chest or abdominal x-ray and function checked by irrigating the tube every 4-8 hours. Drainage from tubes used for decompression should be measured but not for enteral nutrition. Tubes can be removed when the indication is resolved, such as less than 500mL output over 24 hours for bowel obstructions, and a trial clamping may precede removal to check for need to replace.
Nasogastric tubes are used to deliver substances to or drain substances from the stomach. They are commonly used to treat bowel obstructions by decompressing the stomach, administer medications, provide enteral nutrition, or perform stomach lavage. Placement should be confirmed with chest or abdominal x-ray and function checked by irrigating the tube every 4-8 hours. Drainage from tubes used for decompression should be measured but not for enteral nutrition. Tubes can be removed when the indication is resolved, such as less than 500mL output over 24 hours for bowel obstructions, and a trial clamping may precede removal to check for need to replace.
Nasogastric tubes are used to deliver substances to or drain substances from the stomach. They are commonly used to treat bowel obstructions by decompressing the stomach, administer medications, provide enteral nutrition, or perform stomach lavage. Placement should be confirmed with chest or abdominal x-ray and function checked by irrigating the tube every 4-8 hours. Drainage from tubes used for decompression should be measured but not for enteral nutrition. Tubes can be removed when the indication is resolved, such as less than 500mL output over 24 hours for bowel obstructions, and a trial clamping may precede removal to check for need to replace.
Nasogastric tubes are used to deliver substances to or drain substances from the stomach. They are commonly used to treat bowel obstructions by decompressing the stomach, administer medications, provide enteral nutrition, or perform stomach lavage. Placement should be confirmed with chest or abdominal x-ray and function checked by irrigating the tube every 4-8 hours. Drainage from tubes used for decompression should be measured but not for enteral nutrition. Tubes can be removed when the indication is resolved, such as less than 500mL output over 24 hours for bowel obstructions, and a trial clamping may precede removal to check for need to replace.
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- Nasogastric tubes are used both to deliver substances to your stomach and to draw
substances out - Indications: o Treatment of ileus or bowel obstruction –Nasogastric decompression improves patient comfort, minimizes, or prevents recurrent vomiting, and serves as a means to monitor the progress or resolution of these conditions. o Administration of medications – A nasogastric tube may be needed to administer medications, or oral contrast for computed tomography, to patients who cannot swallow or who are neurologically impaired. o Enteral nutrition – Nasogastric and nasoenteric tubes are used to deliver enteral nutrition into the stomach (gastric feeding) or into the small intestine o Stomach lavage – Lavage may be needed to remove blood or clots to facilitate endoscopy - Contraindications: o esophageal stricture or varices o basilar skull fracture or facial fracture
Can we put NGT as prophylaxis after surgery?
Data do not support this belief and most clinicians argue against prophylactic use of nasogastric tubes following surgery How to confirm NGT placement? Various guidelines agree that the placement of all nasogastric and nasoenteric tubes should ideally be documented with a radiograph of the lower chest/upper abdomen How to access NGT function? The function of nasogastric and nasoenteric tubes should be checked frequently by irrigating the tube with water every four to eight hours. When to measure drainage and when not? - The drainage from nasogastric tubes placed for gastrointestinal decompression should be documented to help judge the progression or resolution of obstruction/ileus and the need for supplemental intravenous fluid - The measurement of gastric residual volume, while administering enteral nutrition, does not appear to be necessary and is not feasible when the small flexible tubes are used. However, if a larger-bore nasogastric tube is being used, gastric residuals should be periodically checked to avoid problems related to gastric overdistension When to remove NGT? Nasogastric tubes should be removed when the indication for placement no longer exists. For example, in patients with a small bowel obstruction, a decrease in nasogastric output and the passage of flatus suggest a resolution of the obstruction and that the tube can be safely removed. Pre removal tricks: - A trial of nasogastric drainage to gravity or nasogastric tube clamping are advocated by some as interim maneuvers prior to nasogastric tube removal to minimize the need for tube reinsertion o If a clamping trial is used, one should check the gastric residuals at least every four hours for aspiration risk In case of SBO, no clear data exists on when to remove the NGT. However, in practice there is two methods that is being done: 1. Once the NG tube output is less than 500 mL over a 24 hour period with at least two other signs of return of bowel function the NG tube will be removed. Other signs of bowel function include flatus, bowel movement, change of NG tube output from bilious to more clear/frothy character, and hunger. 2. Once the NG tube output is less than 500 mL over a 24 hour period with at least two other signs of return of bowel function, a 4 hour clamp trial will be performed. Other signs of bowel function include flatus, bowel movement, change of NG tube output from bilious to more clear/frothy character, and hunger. The NG tube will be taken off of suction and clamped. The NG tube is then reconnected to suction at the end of the four hour clamp trial and removed if less 125 mL drains or kept in place if greater than 125 mL drains. The same initial criteria are used again to determine if a clamp trial will be performed after 24 hours.
