From the Guidelines
An NG tube should not remain in place for more than 3-4 weeks due to the risk of sinusitis and other complications, as recommended by the most recent and highest quality study 1. The duration an NG (nasogastric) tube can remain in place typically ranges from 3-4 weeks, though this varies based on the type of tube and clinical situation.
Key Considerations
- Short-term NG tubes made of polyvinyl chloride (PVC) should generally be replaced every 3-7 days, while softer silicone or polyurethane tubes can remain in place for up to 4-6 weeks, as suggested by earlier studies 1.
- For patients requiring longer-term enteral feeding, a more permanent solution like a PEG (percutaneous endoscopic gastrostomy) tube should be considered after 3-4 weeks, as per the latest guidelines 1.
- Regular assessment of the tube's condition is essential, including checking for signs of deterioration, blockage, or complications such as nasal tissue erosion, sinusitis, or aspiration.
- The tube should be replaced immediately if it becomes clogged, damaged, or if the patient develops complications.
Clinical Implications
- Healthcare providers should follow institutional protocols and regularly evaluate the continued need for the tube, removing it as soon as it's no longer clinically necessary.
- A multidisciplinary team approach after enteral access placement provides improved patient care, with dietitians, nurses, and advanced practice clinicians assisting with formula choice, volume, free water needs, and delivery method, as well as tube site assessment and troubleshooting 1.
- The risk of complications, including tissue damage, infection, and tube degradation, increases with prolonged placement, emphasizing the need for careful monitoring and timely removal of the NG tube 1.
From the Research
Duration of NG Tube Placement
- The duration for which an NG tube can be in place is typically limited to a few weeks, as prolonged use can lead to complications such as lesions to the nasal wing, chronic sinusitis, gastro-oesophageal reflux, and aspiration pneumonia 2, 3.
- According to studies, percutaneous endoscopic gastrostomy (PEG) is generally considered a more suitable option for patients who require enteral nutrition for more than 4 weeks 4, 5.
- The use of NG tubes for more than 4 weeks is not recommended due to the increased risk of complications, and PEG is often considered a better alternative for long-term enteral nutrition 4, 5.
- There is no specific maximum duration for NG tube placement, but it is generally recommended to limit its use to a few weeks and consider alternative options like PEG for longer-term nutrition support 2, 3.
Alternatives to NG Tubes
- PEG is a common alternative to NG tubes for long-term enteral nutrition, as it allows for direct access to the stomach and can reduce the risk of complications associated with NG tubes 4, 5.
- Other types of enteral access, such as nasojejunal tubes, may also be considered for patients who require long-term nutrition support 6.
- The choice of enteral access device depends on various factors, including the patient's underlying condition, nutritional needs, and personal preferences 6.