Nasogastric Intubation Questions & Answers

1. Virgilio E, Balducci G, Mercantini P, Giarnieri E, Giovagnoli MR, Montagnini M, et al. Utility of Nasogastric Tube for Medical and Surgical Oncology of Gastric Cancer: A Prospective Institutional Study on a New and Precious Application of an Old and Economic Device. Anticancer Res. 2018 Jan. 38 (1):433-439. [QxMD MEDLINE Link].

2. Lai CJ, Chang WC, Huang CH, Hsiao CF, Cheng YJ. Perioperative gastroesophageal regurgitation in patients with elevated abdominal pressure with nasogastric tubes? A simulation model based on esophageal multichannel intraluminal impedance and pH monitoring. J Formos Med Assoc. 2020 Sep. 119 (9):1435-1438. [QxMD MEDLINE Link]. [Full Text].

3. Tao Z, Zhang Y, Zhu S, Ni Z, You Q, Sun X, et al. A Prospective Randomized Trial Comparing Jejunostomy and Nasogastric Feeding in Minimally Invasive McKeown Esophagectomy. J Gastrointest Surg. 2020 Oct. 24 (10):2187-2196. [QxMD MEDLINE Link].

4. Venara A, Hamel JF, Cotte E, Meillat H, Sage PY, Slim K, et al. Intraoperative nasogastric tube during colorectal surgery may not be mandatory: a propensity score analysis of a prospective database. Surg Endosc. 2020 Dec. 34 (12):5583-5592. [QxMD MEDLINE Link].

5. Kleive D, Sahakyan MA, Labori KJ, Lassen K. Nasogastric Tube on Demand is Rarely Necessary After Pancreatoduodenectomy Within an Enhanced Recovery Pathway. World J Surg. 2019 Oct. 43 (10):2616-2622. [QxMD MEDLINE Link].

6. Fabian T, Robinson T, Naile L, Smith MP, McErlean M. Blind nasogastric tube advancement following sleeve gastrectomy: an animal model. Surg Endosc. 2020 Jan. 34 (1):257-260. [QxMD MEDLINE Link].

7. Cullen L, Taylor D, Taylor S, Chu K. Nebulized lidocaine decreases the discomfort of nasogastric tube insertion: a randomized, double-blind trial. Ann Emerg Med. 2004 Aug. 44 (2):131-7. [QxMD MEDLINE Link].

8. Ducharme J, Matheson K. What is the best topical anesthetic for nasogastric insertion? A comparison of lidocaine gel, lidocaine spray, and atomized cocaine. J Emerg Nurs. 2003 Oct. 29 (5):427-30. [QxMD MEDLINE Link].

9. Middleton RM, Shah A, Kirkpatrick MB. Topical nasal anesthesia for flexible bronchoscopy. A comparison of four methods in normal subjects and in patients undergoing transnasal bronchoscopy. Chest. 1991 May. 99 (5):1093-6. [QxMD MEDLINE Link].

10. West HH. Topical anesthesia for nasogastric tube placement. Ann Emerg Med. 1982 Nov. 11 (11):645. [QxMD MEDLINE Link].

11. Wolfe TR, Fosnocht DE, Linscott MS. Atomized lidocaine as topical anesthesia for nasogastric tube placement: A randomized, double-blind, placebo-controlled trial. Ann Emerg Med. 2000 May. 35 (5):421-5. [QxMD MEDLINE Link].

12. Uri O, Yosefov L, Haim A, Behrbalk E, Halpern P. Lidocaine gel as an anesthetic protocol for nasogastric tube insertion in the ED. Am J Emerg Med. 2011 May. 29 (4):386-90. [QxMD MEDLINE Link].

13. Santos SC, Woith W, Freitas MI, Zeferino EB. Methods to determine the internal length of nasogastric feeding tubes: An integrative review. Int J Nurs Stud. 2016 Jun 15. 61:95-103. [QxMD MEDLINE Link].

14. Fan L, Liu Q, Gui L. Efficacy of nonswallow nasogastric tube intubation: a randomised controlled trial. J Clin Nurs. 2016 Nov. 25 (21-22):3326-3332. [QxMD MEDLINE Link].

15. Bennetzen LV, Håkonsen SJ, Svenningsen H, Larsen P. Diagnostic accuracy of methods used to verify nasogastric tube position in mechanically ventilated adult patients: a systematic review. JBI Database System Rev Implement Rep. 2015 Feb 13. 13 (1):188-223. [QxMD MEDLINE Link].

16. Torsy T, Saman R, Boeykens K, Eriksson M, Verhaeghe S, Beeckman D. Factors associated with insufficient nasogastric tube visibility on X-ray: a retrospective analysis. Eur Radiol. 2021 Apr. 31 (4):2444-2450. [QxMD MEDLINE Link].

17. Choi E, Korostensky M, Walker A, Spencer A. Validation of sonographic assistance for placement of a nasogastric tube in pediatric patients. J Clin Ultrasound. 2021 Feb. 49 (2):101-105. [QxMD MEDLINE Link].

18. Hsieh SW, Chen HS, Chen YT, Hung KC. To characterize the incidence of airway misplacement of nasogastric tubes in anesthetized intubated patients by using a manometer technique. J Clin Monit Comput. 2017 Apr. 31 (2):443-448. [QxMD MEDLINE Link].

19. Chun DH, Kim NY, Shin YS, Kim SH. A randomized, clinical trial of frozen versus standard nasogastric tube placement. World J Surg. 2009 Sep. 33 (9):1789-92. [QxMD MEDLINE Link].

20. Moharari RS, Fallah AH, Khajavi MR, Khashayar P, Lakeh MM, Najafi A. The GlideScope facilitates nasogastric tube insertion: a randomized clinical trial. Anesth Analg. 2010 Jan 1. 110 (1):115-8. [QxMD MEDLINE Link].

21. Li J, Feng YM, Wan D, Deng HS, Guo R. A new strategy for enteral nutrition using a deflection flexible visual gastric tube: A randomized crossover manikin trial. Medicine (Baltimore). 2018 May. 97 (20):e10742. [QxMD MEDLINE Link]. [Full Text].

22. Lee XL, Yeh LC, Jin YD, Chen CC, Lee MH, Huang PW. Nasogastric tube placement with video-guided laryngoscope: A manikin simulator study. J Chin Med Assoc. 2017 Aug. 80 (8):492-497. [QxMD MEDLINE Link]. [Full Text].

23. Kavakli AS, Kavrut Ozturk N, Karaveli A, Onuk AA, Ozyurek L, Inanoglu K. [Comparison of different methods of nasogastric tube insertion in anesthetized and intubated patients]. Rev Bras Anestesiol. 2017 Nov - Dec. 67 (6):578-583. [QxMD MEDLINE Link]. [Full Text].

24. Bourgault AM, Halm MA. Feeding tube placement in adults: safe verification method for blindly inserted tubes. Am J Crit Care. 2009 Jan. 18 (1):73-6. [QxMD MEDLINE Link].

25. Metheny NA, Stewart BJ, Mills AC. Blind insertion of feeding tubes in intensive care units: a national survey. Am J Crit Care. 2012 Sep. 21 (5):352-60. [QxMD MEDLINE Link].

26. Appukutty J, Shroff PP. Nasogastric tube insertion using different techniques in anesthetized patients: a prospective, randomized study. Anesth Analg. 2009 Sep. 109 (3):832-5. [QxMD MEDLINE Link].

27. Sharma A, Vyas V, Goyal S, Bhatia P, Sethi P, Goel AD. Nasogastric tube insertion using conventional versus bubble technique for its confirmation in anesthetized patients: a prospective randomized study. Braz J Anesthesiol. 2021 Mar 22. [QxMD MEDLINE Link]. [Full Text].

28. Taylor N, Bamford T, Haindl C, Cracknell A. Discovering Innovation at the Intersection of Undergraduate Medical Education, Human Factors, and Collaboration: The Development of a Nasogastric Tube Safety Pack. Acad Med. 2016 Apr. 91 (4):512-6. [QxMD MEDLINE Link]. [Full Text].

29. Okada Y, Ohke H, Yoshimoto H, Kobashi M, Saitoh M, Terumitsu M. Nasogastric Tube Knotted Around a Nasal Endotracheal Tube in the Nasopharynx: Possible Cause. Anesth Prog. 2021 Jun 1. 68 (2):90-93. [QxMD MEDLINE Link]. [Full Text].

30. Motta APG, Rigobello MCG, Silveira RCCP, Gimenes FRE. Nasogastric/nasoenteric tube-related adverse events: an integrative review. Rev Lat Am Enfermagem. 2021. 29:e3400. [QxMD MEDLINE Link]. [Full Text].

Gil Z Shlamovitz, MD, FACEP Associate Professor of Clinical Emergency Medicine, Keck School of Medicine of the University of Southern California; Chief Medical Information Officer, Keck Medicine of USC

Gil Z Shlamovitz, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association

Disclosure: Nothing to disclose.

Nirav R Shah, MD, MPH Senior Scholar, Stanford University School of Medicine

Nirav R Shah, MD, MPH is a member of the following medical societies: American College of Physicians, New York Academy of Medicine, Society of General Internal Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Luis M Lovato, MD Associate Clinical Professor, University of California, Los Angeles, David Geffen School of Medicine; Director of Critical Care, Department of Emergency Medicine, Olive View-UCLA Medical Center

Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Vikram Kate, MBBS, PhD, MS, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, FFST(Ed), MAMS, MASCRS Professor of General and Gastrointestinal Surgery and Senior Consultant Surgeon, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), India

Vikram Kate, MBBS, PhD, MS, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, FFST(Ed), MAMS, MASCRS is a member of the following medical societies: American College of Gastroenterology, American College of Surgeons, American Society of Colon and Rectal Surgeons, Fellow of the Faculty of Surgical Trainers (RCSEd), Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of England, Society for Surgery of the Alimentary Tract

Disclosure: Nothing to disclose.

Andrew K Chang, MD, MS Vincent P Verdile, MD, Endowed Chair in Emergency Medicine, Professor of Emergency Medicine, Vice Chair of Research and Academic Affairs, Albany Medical College; Associate Professor of Clinical Emergency Medicine, Albert Einstein College of Medicine; Attending Physician, Department of Emergency Medicine, Montefiore Medical Center

Andrew K Chang, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American Academy of Pain Medicine, American College of Emergency Physicians, American Geriatrics Society, American Pain Society, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

The Chief Editor would like to acknowledge the assistance of Dr Gurushankari Balakrishnan, Surgical Oncology Resident, Cancer Institute (WIA), Adyar, Chennai, India; and of Dr Mohsina Subair, former Senior Resident, Department of Surgery, Dr Archana Elangovan, former Senior Resident, Department of Surgery, and Dr Evangeline Mary Kiruba Samuel, Junior Resident, Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, in updating the review of this article.

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