Nasogastric intubation

Nasogastric intubation
Intervention
Stomach tube (Levin type), 18 Fr × 48 in (121 cm)
ICD-9-CM	96.07, 96.6
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Nasogastric intubation is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose, past the throat, and down into the stomach. Orogastric intubation is a similar process involving the insertion of a plastic tube (orogastric tube) through the mouth.

As a sump tube where the physician desires to keep the stomach continuously and completely evacuated of swallowed air, swallowed saliva, gastric secretions or fresh blood the nasogastric (NG) tube is used with a vacuum source. The original Levin tube failed Dr. Harold W. Andersen in 1958 and he endeavored to engineer a double-lumen NG tube to reduce the vacuum of the aspiration lumen by adding a vent lumen to the outside including an anti-reflux filter at the proximal end of the vent lumen and additional markings for placing the tube in the patient. This was the first double-lumen nasogastric tube. [1][2]

A nasogastric tube is used for feeding and administering drugs and other oral agents such as activated charcoal. For drugs and for minimal quantities of liquid, a syringe is used for injection into the tube. For continuous feeding, a gravity based system is employed, with the solution placed higher than the patient's stomach. If accrued supervision is required for the feeding, the tube is often connected to an electronic pump which can control and measure the patient's intake and signal any interruption in the feeding.

Nasogastric aspiration (suction) is the process of draining the stomach's contents via the tube. Nasogastric aspiration is mainly used to remove gastrointestinal secretions and swallowed air in patients with gastrointestinal obstructions. Nasogastric aspiration can also be used in poisoning situations when a potentially toxic liquid has been ingested, for preparation before surgery under anaesthesia, and to extract samples of gastric liquid for analysis.

If the tube is to be used for continuous drainage, it is usually appended to a collector bag placed below the level of the patient's stomach; gravity empties the stomach's contents. It can also be appended to a suction system, however this method is often restricted to emergency situations, as the constant suction can easily damage the stomach's lining. In non-emergency situations, intermittent suction is often applied giving the benefits of suction without the untoward effects of damage to the stomach lining.