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Nasogastric intubation
Medical expert of the article
Last reviewed: 06.07.2025
[ Technique for performing nasogastric intubation
Several types of tubes are used for intubation. Levin or Salem tubes are used for gastric decompression or gastric sampling and, rarely, for short-term feeding. Various long, thin intestinal tubes are used for long-term enteral feeding.
During probing, the patient sits upright or, if necessary, the examination is carried out lying on the side.
Irrigation of the nasal and pharyngeal mucosa with a local anesthetic reduces discomfort. The patient's head is slightly bent, the probe after treatment with an ointment is inserted into the nasal passage and advanced first backwards and then downwards according to the nasopharynx. Since the end of the probe reaches the pharyngeal wall, it is advisable for the patient to sip water through a straw. A strong cough with air entering through the probe during breathing indicates the localization of the probe in the trachea. Aspiration of gastric juice through the probe confirms its location in the stomach. The position of the probe in the stomach can also be identified by introducing 20-30 ml of air into the probe with simultaneous auscultation with a stethoscope in the left hypochondrium, revealing the noise of incoming air.
Thinner, more flexible intestinal feeding tubes require the use of rigid guidewires or stylets. Fluoroscopy or endoscopy is required to guide these tubes through the pyloric canal.
Nasogastric intubation: contraindications
Contraindications to nasogastric intubation include nasopharyngeal or esophageal obstruction, severe maxillofacial trauma, and uncorrectable coagulation disorders. Esophageal varices were initially considered a contraindication, but no convincing evidence of adverse effects has been reported.
Complications of nasogastric intubation
Complications of nasogastric intubation are rare and include varying degrees of nasopharyngeal injury with or without resulting bleeding, pulmonary aspiration, esophageal or gastric injury with bleeding or perforation, and (very rarely) intracranial or mediastinal penetration.