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NASOGASTRIC INTUBATION

NASOGASTRIC INTUBATION. Ayşe Arzu Akalın MD. Nasogastric tubes are flexible plastic tubes that are passed proximally from the nose distally into the stomach . INDICATIONS . Aspirate stomach contents Diagnostic or therapeutic Assessment of GI bleeding Determine gastric acid content.

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NASOGASTRIC INTUBATION

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  1. NASOGASTRIC INTUBATION Ayşe Arzu Akalın MD

  2. Nasogastric tubes are flexible plastic tubes that are passed proximally from the nose distally into the stomach.

  3. INDICATIONS  • Aspirate stomach contents • Diagnostic or therapeutic • Assessment of GI bleeding • Determine gastric acid content

  4. INDICATIONS  • Treatment of ileus or bowel obstruction – Nasogastric decompression improves patient discomfort, minimizes or prevents recurrent vomiting, and serves as means to monitor the progress or resolution of these conditions. • Administration of medications –likeoral contrast for computed tomography, charcoal • Enteral nutrition – Nasogastrictubes are used to deliver enteral nutrition into the stomach (gastric feeding) or into the small intestine (post-pyloric). • Gastriclavage– Lavage may be needed to remove blood or clots to facilitate endoscopy.

  5. CONTRAINDICATIONS Nasogastricintubation is contraindicated in patients with; • esophageal stricture because of the risk for esophageal perforation, • esophageal varicesbecause tube placement may trigger variceal bleeding which can be life-threatening • basilar skull fracture or facial fracture due to the potential for intracranial misplacement • a bleeding diathesis, minimal trauma to the pharynx, esophagus, or stomach from nasogastric tubes can also lead to severe bleeding and, thus, tubes are avoided whenever possible.

  6. COMPLICATIONSGastrointestinal • Malposition, coiling or knotting of tubes. Pharyngeal and pyriform sinus misplacement • The presence of a nasogastric or nasoenteric tube impairs the normal function of the lower esophageal sphincter, making the patient more susceptible to reflux of gastric contents which may lead to esophagitis, gastrointestinal bleeding or pulmonary aspiration. • Nasogastric tubes can cause gastritis or gastric bleedingdue to chronic irritation or pressure necrosis due to suctioning of the gastrointestinal mucosa [

  7. COMPLICATIONSPulmonary  • Intubation of the lung and inadvertent administration of medications, radiocontrast media or enteral formula through the malpositionedtube can lead to pneumonia. Pulmonary abscess may result. • Tracheal perforation and pneumothorax

  8. COMPLICATIONS • Nasal alar ulceration or necrosis — improperly securing the tube or placement of too large a tube. Frequent re-taping of the tube to decrease pressure on any particular point may help to prevent this complication. • Perforation — Patients with prior esophageal or gastric surgery are at risk for gastrointestinal perforation and infants, children and patients with facial trauma are at risk for cribriform plate perforation and intracranial intubation

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