Generality
The nasogastric tube is a long and flexible tube which, introduced into the stomach starting from the nose, can be used to:
- the administration of nutrients,
- the "elimination of a certain undesirable gastric content (gas, blood, accidentally ingested objects, etc.),
- gastric lavage,
- gastric decompression,
- the administration of drugs
- lung expansion (is a contributing factor).
Made of polyurethane, PVC or silicone, modern nasogastric tubes are medical devices suitable for short / medium term use; their prolonged use, in fact, can cause unpleasant side effects.
There are two main types of nasogastric tube: the single lumen nasogastric tube, known as the Levin tube, and the double lumen nasogastric tube, known as the Salem tube. These two types of nasogastric tube differ in characteristics such as diameter or maximum length, and in clinical indications.
The introduction of the nasogastric tube into the stomach of an individual is a rather delicate procedure, which requires a certain skill and experience, on the part of the person who performs it.
What is the nasogastric tube?
The nasogastric tube is a long and flexible tube which, inserted into the nose and carried up to the stomach through the pharynx and the esophagus, can serve various purposes, including mainly: the administration of nutrients and the elimination of a certain content undesirable gastric.
Also known as a nasogastric tube, the nasogastric tube is in effect a medical device.
Indications
Doctors resort to the use of the nasogastric tube for:
- Provide artificial nutrition for people who are unable or refuse to eat.
Artificial nutrition made with a nasogastric tube is a form of enteral nutrition, specifically called enteral nutrition through a nasogastric tube; - Empty the stomach of unwanted food, gas, blood or accidentally ingested foreign objects (clearly they can pass through the tube);
- Cleansing the stomach of highly dangerous toxic substances or an overdose of drugs / narcotics. The stomach cleaning procedure, carried out through a nasogastric tube, is called gastric lavage or gastric irrigation;
- Provide the so-called gastric decompression as a form of prevention of vomiting and treatment of gastric distension, in people with an "intestinal obstruction;
- Giving medications to people who are unconscious or have difficulty swallowing;
- Promote lung expansion in unconscious and mechanically ventilated subjects.
Normally, the nasogastric tube represents a short / medium term solution, regardless of the indications, as its prolonged use can be very annoying and cause unpleasant side effects.
Therefore, taking for example enteral nutrition through a nasogastric tube, the use of the latter is indicated:
- In the early stages of an "eventual inability or unwillingness to eat. After that, there is a transition to" another form of artificial nutrition (enteral or parenteral);
or
- When a rapid recovery of the ability to feed independently is expected. If these conditions are lacking, doctors immediately prefer to resort to forms of artificial nutrition designed specifically for their prolonged use.
- Assessment of suspected upper gastrointestinal bleeding;
- Collection and analysis of gastric juice;
- Help in the identification, on an X-ray plate, of the esophagus and stomach;
- Administration of a contrast medium in the upper gastrointestinal tract.
Therapeutic indications
- Gastric decompression, in people with an "intestinal obstruction;
- Administration of drugs, in people with difficulty in swallowing;
- Aspiration of unwanted gastric contents (e.g. food, blood, foreign objects, toxic substances). It is the procedure known as gastric lavage;
- Enteral feeding, in people with serious difficulties in eating and in those who have problems with the esophagus (eg corrosion of the esophageal tract);
MORE INFORMATION ON ENTERAL NUTRITION
In medicine, any form of artificial nutrition is called enteral, performed by means of a tube (or probe) that opens into a tract of the digestive system and, here, releases nutrients from an external resource.
There are at least 4 different types of enteral nutrition:
- The aforementioned enteral nutrition through a nasogastric tube;
- Enteral nutrition called PEG (Percutaneous Endoscopic Gastrostomy). This involves inserting the feeding probe into the stomach, through a hole made on the abdomen and on the wall of the stomach itself;
- The jejunostomy, which takes up the principles of the PEG with the only difference that the insertion of the probe takes place in the jejunum, that is a section of the small intestine;
- Enteral feeding through a naso-jejunal tube differs from enteral feeding through a nasogastric tube for the sole fact that the feeding tube opens into the intestinal tract called jejunum.
Features
There are two types of nasogastric tube: the nasogastric tube known as the "Levin tube" and the nasogastric tube known as the "Salem tube".
LEVIN PROBE
The Levin probe is a nasogastric tube with a single lumen, maximum 125 cm long and having a diameter ranging from 6 to 18 French (N.B: a French or French unit equals 0.33mm).
It can be used in enteral nutrition, in gastric decompression (in the presence of intestinal obstruction), in the washing of the stomach from dangerous toxic substances (gastric lavage) and in the aspiration of blood from the gastric compartment (ie from the stomach).