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Nasogastric Tube Insertion Length Measurement and Tip Verification in Adults: a Narrative Review

Overview
Journal Crit Care
Specialty Critical Care
Date 2023 Aug 18
PMID 37596615
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Abstract

Nasogastric feeding tube insertion is a common but invasive procedure most often blindly placed by nurses in acute and chronic care settings. Although usually not harmful, serious and fatal complications with misplacement still occur and variation in practice still exists. These tubes can be used for drainage or administration of fluids, drugs and/or enteral feeding. During blind insertion, it is important to achieve correct tip position of the tube ideally reaching the body of the stomach. If the insertion length is too short, the tip and/or distal side-openings at the end of the tube can be located in the esophagus increasing the risk of aspiration (pneumonia). Conversely, when the insertion length is too long, the tube might kink in the stomach, curl upwards into the esophagus or enter the duodenum. Studies have demonstrated that the most frequently used technique to determine insertion length (the nose-earlobe-xiphoid method) is too short a distance; new safer methods should be used and further more robust evidence is needed. After blind placement, verifying correct gastric tip positioning is of major importance to avoid serious and sometimes lethal complications.

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References
1.
Brazier S, Taylor S, Allan K, Clemente R, Toher D . Stroke: ineffective tube securement reduces nutrition and drug treatment. Br J Nurs. 2017; 26(12):656-663. DOI: 10.12968/bjon.2017.26.12.656. View

2.
Powers J, Brown B, Lyman B, Escuro A, Linford L, Gorsuch K . Development of a Competency Model for Placement and Verification of Nasogastric and Nasoenteric Feeding Tubes for Adult Hospitalized Patients. Nutr Clin Pract. 2021; 36(3):517-533. DOI: 10.1002/ncp.10671. View

3.
Fernandez R, Chau J, Thompson D, Griffiths R, Lo H . Accuracy of biochemical markers for predicting nasogastric tube placement in adults--a systematic review of diagnostic studies. Int J Nurs Stud. 2010; 47(8):1037-46. DOI: 10.1016/j.ijnurstu.2010.03.015. View

4.
Torsy T, Saman R, Boeykens K, Duysburgh I, Eriksson M, Verhaeghe S . Accuracy of the corrected nose-earlobe-xiphoid distance formula for determining nasogastric feeding tube insertion length in intensive care unit patients: A prospective observational study. Int J Nurs Stud. 2020; 110:103614. DOI: 10.1016/j.ijnurstu.2020.103614. View

5.
Sparks D, Chase D, Coughlin L, Perry E . Pulmonary complications of 9931 narrow-bore nasoenteric tubes during blind placement: a critical review. JPEN J Parenter Enteral Nutr. 2011; 35(5):625-9. DOI: 10.1177/0148607111413898. View