Why should a Nasogastric (NG) tube be on intermittent suction?

From the Guidelines

Nasogastric (NG) tubes should be placed on intermittent suction to minimize complications and maintain the integrity of the gastric mucosa, as there is no direct evidence to support continuous suction in the provided guidelines. When considering the management of NG tubes, it's essential to focus on the principles of minimizing trauma and complications while achieving the desired therapeutic effect.

• Intermittent suction allows for periodic relief from negative pressure, which can help prevent damage to the gastric mucosa.
• The provided guidelines do not directly address the suction settings for NG tubes, but they emphasize the importance of proper tube placement and verification before use 1.
• In clinical practice, intermittent suction typically involves cycles of suction followed by periods without suction, allowing for the assessment of gastric contents and the adjustment of suction settings as needed.
• Healthcare providers should follow their facility's protocol for suction pressure settings and regularly assess the patient for signs of dehydration, electrolyte abnormalities, or tube-related complications.
• The guidelines highlight the importance of using fine bore NG tubes unless there is a specific need for repeated gastric aspiration or administration of high viscosity feeds/drugs via the tube 1.
• While the guidelines do not explicitly recommend intermittent suction, they emphasize the need for careful management of NG tubes to prevent complications, which supports the use of intermittent suction as a best practice.

From the Research

Importance of Intermittent Suction for Nasogastric (NG) Tubes

• The provided studies do not directly address why a Nasogastric (NG) tube should be on intermittent suction.
• However, the studies discuss the importance of proper placement and maintenance of NG tubes to avoid complications 2, 3, 4, 5, 6.
• The use of intermittent suction may be related to the prevention of complications such as aspiration pneumonia, which is mentioned as a potential risk associated with NG tube placement 3.
• Additionally, the studies highlight the need for careful monitoring and verification of NG tube placement to prevent misplacement and related complications 5, 6.

Complications Associated with NG Tube Placement

• The studies discuss various complications associated with NG tube placement, including epistaxis, pneumothorax, and fatal perforations 5.
• The importance of confirming the correct position of the NG tube through radiography, pH testing, or other methods is emphasized to reduce the incidence of complications 6.
• The use of intermittent suction may be a strategy to minimize the risk of complications, although this is not explicitly stated in the provided studies.

Best Practices for NG Tube Placement and Maintenance

• The studies emphasize the need for a multidisciplinary team approach and good coordination to implement best practices for NG tube placement and maintenance 6.
• The importance of monitoring and evaluating the impact of new practices on patients, nurses, and other healthcare professionals is also highlighted 6.
• While the studies do not directly address the use of intermittent suction, they provide guidance on best practices for NG tube placement and maintenance, which may inform the use of suction as part of overall NG tube management 2, 3, 4, 5, 6.