0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Effect of Nasogastric Tube Size on Gastroesophageal Reflux and Microaspiration in Intubated Patients

Miquel Ferrer, MD; Torsten Thomas Bauer, MD; Antoni Torres, MD, PhD; Carmen Hernández, RN; and Carlos Piera, PhD
[+] Article and Author Information

From the University of Barcelona, Barcelona, Spain.


Ann Intern Med. 1999;130(12):991-994. doi:10.7326/0003-4819-130-12-199906150-00007
Text Size: A A A

Background: Little evidence exists to support the theory that small-bore nasogastric tubes prevent gastroesophageal reflux and microaspiration in intubated patients.

Objective: To determine whether gastroesophageal reflux and microaspiration in intubated patients can be reduced by the use of a small-bore nasogastric tube.

Design: Randomized, two-period crossover trial.

Setting: Respiratory intensive care unit of a university hospital.

Patients: 17 patients intubated for more than 72 hours.

Interventions: Radioactive technetium colloid was instilled in each patient's stomach. Patients were studied with two nasogastric tubes (one tube with a 6.0-mm external bore and one tube with a 2.85-mm external bore) in randomized order; measurements of radioactive counts with the alternate size of nasogastric tube were repeated 72 hours after original measurements were taken. Sequential samples of serum, gastric juice, and pharyngeal and tracheal secretions were obtained.

Measurements: Comparison of the time course of radioactive counting in all samples (obtained during the use of each nasogastric tube size in each patient).

Results: The mean radioactive count of pharyngeal aspirates (P = 0.004) was greater than the baseline count at all time points, as was the cumulative radioactive count of pharyngeal aspirates 17 hours after the first dose of technetium colloid was administered (P = 0.001); however, the count of tracheal aspirates was never greater than the count at baseline. No differences were found between tube types when the time course and cumulative counts of pharyngeal and tracheal samples were compared.

Conclusion: Small-bore nasogastric tubes in intubated patients do not reduce gastroesophageal reflux or microaspiration.

Figures

Grahic Jump Location
Figure 1.
Scintigraphic radioactivity counts (mean cpm [log 10 ] ±SE) of pharyngeal aspirates (top left), tracheal aspirates (top right), gastric aspirates (bottom left), and serum (bottom right).

White squares represent small-bore nasogastric tubes; black squares represent large-bore nasogastric tubes. cpm = counts per minute.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Scintigraphic 17-hour cumulative radioactive counts (mean cpm [log 10 ] ±SE) of pharyngeal aspirates (left) and tracheal aspirates (right).

White squares represent small-bore nasogastric tubes; black squares represent large-bore nasogastric tubes. cpm = counts per minute.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)