A novel detection method for pharyngeal nasogastric tube crossing to prevent nasogastric tube syndrome.

OBJECTIVE

Nasogastric tube (NGT) placement can sometimes cause discomfort and pharyngeal injury. We determined the frequency of pharyngeal NGT crossing (PNGTC) in patients with an NGT and evaluated whether visual assessment of the NGT course in the oropharynx could serve as a useful screening method for detecting PNGTC.

METHODS

We retrospectively analyzed data from 100 patients with an NGT in place who underwent videoendoscopic evaluation of swallowing (n = 462) at our hospital between April 2020 and December 2022. The frequency of PNGTC was determined. In addition, we evaluated the relationship between the position of the NGT at the level of the oropharynx, as observed from the oral cavity-classified as the same side as the nasal cavity entrance, center, or opposite side-and the presence of PNGTC.

RESULTS

PNGTC was identified in 56 of 100 patients (56%). PNGTC was observed in 4 of 47 patients (8.5%) with the NGT on the same side, in 37 of 38 patients (97.4%) with a midline course, and in all 15 patients with the NGT on the opposite side. The association between oropharyngeal NGT position and the presence of PNGTC was statistically significant (P < 0.001). Visual confirmation of the NGT trajectory at the oropharyngeal level demonstrated a sensitivity of 91.5% and a specificity of 98.1%.

CONCLUSION

Visual assessment of the NGT course at the level of the oropharynx may be useful for predicting PNGTC. This approach may help prevent complications and reduce discomfort associated with NGT placement.