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Thoracic complications of nasogastric tube: review of safe practice

^a Division of Cardiac Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, 200 Elizabeth Street, Toronto, Canada M5G 2C4
^b Department of Cardiac Anaesthesia and Intensive Care, Peter Munk Cardiac Centre, Toronto General Hospital, 200 Elizabeth Street, Toronto, Canada M5G 2C4

*Corresponding author: Dr J.B. Pillai, 17 Paxford Close, Vicars Lane, Benton, Newcastle upon Tyne NE7 7PA, UK Tel.: +44 (0) 191 266 5472; fax: +44 (0) 191 213 1968.

E-mail address: jain_freeman{at}hotmail.com (J.B. Pillai).

Objective: Insertion of a nasogastric tube, though a common clinical procedure, can produce unexpected complications. We sought to analyse the procedure, and explore means to improve its safety. Methods: We present a case with a thoracic complication. We review the English literature for the range of complications, and collate all available clinical tests used to confirm enteric placement. Results: We discuss the short-comings of the usual clinical tests and emphasise the more recent, but less mainstream, procedures that introduce more objectivity to the enteric tube placement. Conclusions: We provide summary points to guide the clinician in everyday practice.

Key Words: Nasogastric tube; Enteral feeding; Fine-bore feeding tube

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