Prophylactic nasogastric decompression after abdominal surgery

Nelson, Richard L.; Edwards, S. Albert; Tse, Bonnie

doi:10.1002/14651858.cd004929.pub2

Cited by 184 publications

(224 citation statements)

References 21 publications

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“…As expected, the use of gastric tubes did not influence the clinical course of patients with aspiration pneumonia [7]. Together with the fact that nasogastric tubes do not protect patients from pulmonary aspiration, we support the recommendations in the current literature to abandon routine nasogastric decompression tubes in elective surgical patients [7].…”

Section: Discussionsupporting

confidence: 84%

“…Together with the fact that nasogastric tubes do not protect patients from pulmonary aspiration, we support the recommendations in the current literature to abandon routine nasogastric decompression tubes in elective surgical patients [7].…”

Section: Discussionsupporting

confidence: 81%

“…The 30° elevation of the upper body has been shown to reduce the risk of aspiration pneumonia in the intensive care unit (ICU) [6]. Routine nasogastric decompression tubes [7] or percutaneous feeding tubes instead of nasogastric feeding tubes have not been shown to reduce the risk of pulmonary aspiration [8].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia

Studer

Räber

Ott

et al. 2016

International Journal of Surgery

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2 Highlights-Postoperative aspiration pneumonia is a rare complication, however, remains a severe disease with a significant mortality of 27% in this series.-Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia.-The identification of those patients at increased risk for death after aspiration may help to further improve patients outcome. Conclusion: Postoperative aspiration pneumonia remains a severe complication with significant mortality. Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia. Therefore, these patients suffering aspiration pneumonia require special attention and increased monitoring.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 81%

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Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia

Studer

Räber

Ott

et al. 2016

International Journal of Surgery

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“…58 There was no significant increase in other complications. A recent meta-analysis, including 1416 patients from 7 trials, in patients undergoing elective colorectal surgery reported similar results.…”

Section: Avoidance Of Nasogastric Tubesmentioning

confidence: 82%

Enhanced Recovery after Surgery

Lsmu¹,

klinika²,

nuskausminimas³

et al. 2018

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Enhanced Recovery or Fast Track Recovery after Surgery protocols (ERAS) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery.The present systematic review aimed to examine the impact on the magnitude of the systemic inflammatory response (SIR) for each ERAS component following colorectal surgery using objective markers such as C-reactive protein (CRP) and interleukin-6 (IL-6).A literature search was performed of the US National Library of Medicine (MEDLINE), EMBASE, PubMed, and the Cochrane Database of Systematic Reviews using appropriate keywords and subject headings to February 2015.Included studies had to assess the impact of the selected ERAS component on the SIR using either CRP or IL-6. Nineteen studies, including 1898 patients, were included. Fourteen studies (1246 patients) examined the impact of laparoscopic surgery on the postoperative markers of SIR. Ten of these studies (1040 patients) reported that laparoscopic surgery reduced postoperative CRP. One study (53 patients) reported reduced postoperative CRP using opioidminimising analgesia. One study (142 patients) reported no change in postoperative CRP following preoperative carbohydrate loading. Two studies (108 patients) reported conflicting results with respect to the impact of goal-directed fluid therapy on postoperative IL-6. No studies examined the effect of other ERAS components, including mechanical bowel preparation, antibiotic prophylaxis, thromboprophylaxis, and avoidance of nasogastric tubes and peritoneal drains on markers of the postoperative SIR following colorectal surgery.The present systematic review shows that, with the exception of laparoscopic surgery, objective evidence of the effect of individual components of ERAS protocols in reducing the stress response following colorectal surgery is limited.(Medicine 94(36):e1286)Abbreviations: CRP = C-reactive protein, EA = epidural analgesia, ERAS = Enhanced Recovery After Surgery, IL-6 = interleukin-6, LA = local anaesthetic, LMWH = low molecular weight heparin, MBP = mechanical bowel preparation, NSAID = non-steroidal anti-inflammatory drug, SIR = systemic inflammatory response, TAP = transversus abdominis plane, TNF = tumor necrosis factor.

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“…There is no evidence to suggest that routine nasogastric drainage improves outcomes and patients with a nasogastric tube in situ have a higher incidence of atelectasis and pneumonia [14]. Nasogastric tubes should not be inserted routinely.…”

Section: Optimising Intra-operative Patient Carementioning

confidence: 99%