A novel method to assist nasogastric tube insertion

Hung, Chun Wai; Wh, Lee

doi:10.1136/emj.2007.049312

Cited by 25 publications

(26 citation statements)

References 10 publications

(6 reference statements)

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“…org/nasogastric-tube-insertion-the-simple-yet-impossible/ accessed 11 Nov 2016). Table 2 shows different RCTs concering NGT insertion methods [62][63][64][65][66][67][68][69][70][71][72][73][74][75].…”

Section: By Equipment Minor Majormentioning

confidence: 99%

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

Sanaie

Mahmoodpoor

Najafi

2017

Anaesthesiol Intensive Ther

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Nasogastric tubes (NGT) still remain the easiest and the best way for gastrointestinal tract access. There are various indications for the insertion of a nasogastric tube in anaesthetized and critically ill patients. Although many techniques have been introduced to facilitate nasogastric tube insertion using anatomic landmarks and a group of devices, there is no consensus on a standard method. Moreover, there are different methods for the assessment of the correct placement of a nasogastric tube. In addition to these challenges in insertion and assessment methods, there are varieties of major life-threatening and minor complications to be addressed. Thus, selecting the most appropriate approach requires enough knowledge in this area, considering patient condition and clinical factors, as well as the practitioners' sufficient education and experience, along with skill in performance. This is a comprehensive review of the literature evidence on different methods for nasogastric tube insertion, on the assessment of correct placement and the evaluation of complications, in addition to an approach to the effect of education on the quality of routine practice and patients' outcome.

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Section: By Equipment Minor Majormentioning

confidence: 99%

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

Sanaie

Mahmoodpoor

Najafi

2017

Anaesthesiol Intensive Ther

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“…Other methods of increasing the success rate include the use of a slit endotracheal tube placed via the nasoesophageal route [5], the use of a laryngoscope with Magill forceps [8], and gloved-finger steering to navigate the NGT [3]. Some reports suggest that NGT flexibility is significantly affected by NGT insertion [3810111213]. These methods have been introduced to harden the NGT: the ice-water method [9], placing the NGT in a refrigerator [4], the air or water-filled method [1011], freezing with distilled water [12], and using a large-caliber NGT [13].…”

Section: Discussionmentioning

confidence: 99%

“…Some reports suggest that NGT flexibility is significantly affected by NGT insertion [3810111213]. These methods have been introduced to harden the NGT: the ice-water method [9], placing the NGT in a refrigerator [4], the air or water-filled method [1011], freezing with distilled water [12], and using a large-caliber NGT [13]. Others methods include using a hard substance, such as a guidewire, inside the NGT to increase stiffness [5].…”

Section: Discussionmentioning

confidence: 99%

Nasogastric tube insertion using airway tube exchanger in anesthetized and intubated patients

Kim

Lee

Cho³

et al. 2016

Korean J Anesthesiol

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BackgroundA nasogastric tube (NGT) is commonly inserted into patients undergoing abdominal surgery to decompress the stomach during or after surgery. However, for anatomic reasons, the insertion of NGTs into anesthetized and intubated patients may be challenging. We hypothesized that the use of a tube exchanger for NGT insertion could increase the success rate and reduce complications.MethodsOne hundred adult patients, aged 20–70 years, who were scheduled for gastrointestinal surgeries with general anesthesia and NGT insertion were enrolled in our study. The patients were randomly allocated to the tube-exchanger group or the control group. The number of attempts, the time required for successful NGT insertion, and the complications were noted for each patient.ResultsIn the tube-exchanger group, the success rate of NGT insertion on the first attempt was 92%, which is significantly higher than 68%, the rate in the control group (P = 0.007). The time required for successful NGT insertion in the tube-exchanger group was 18.5 ± 8.2 seconds, which is significantly shorter than the control group, 75.1 ± 9.8 seconds (P < 0.001). Complications such as laryngeal bleeding and the kinking and knotting of the NGT occurred less often in the tube-exchanger group.ConclusionsThere were many advantages in using a tube-exchanger as a guide to inserting NGTs in anesthetized and intubated patients. Compared to the conventional technique, the use of a tube-exchanger resulted in a higher the success rate of insertion on the first attempt, a shorter procedure time, and fewer complications.

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“…Other authors have achieved success by adopting a Seldinger technique5 and following guidance using a flexible nasoendoscope 6 7. Increased success has been also described anecdotally following stiffening the tube by freezing or by filling the gastric tubes with water8 and then spiggoting before attempted insertion. A fundamental limitation of many of these described techniques, however, is attempting to pass an inherently linear tube down a tortuous track in a blinded fashion.…”

Section: Discussionmentioning

confidence: 99%