Naogastric tube

  1. Is there a possiblity that a nasogastric tube is inserted into the esophagus without reaching the stomach, yet aspirate less than pH5 can still be obtained, such as in a patient with GERD?
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    About tkyeung

    Joined: Feb '14; Posts: 39


  3. by   Clovery
    I recently wrote a paper related to enteral feeding tubes so I had a reference handy...
    This is from the Journal of Parenteral and Enteral Nutrition: Enteral Nutrition Practice Recommendations
    quotes are from p. 23

    "The appearance and pH of aspirates from a feeding tube mayprovide useful clues to an enteral access device location.
    For example, fluid withdrawn from a tube that has perforated
    into the pleural space typically has a pale yellow
    serous appearance and a pH of 7 or higher, while fasting
    gastric fluid typically is clear and colorless or grassy green
    with a pH of 5 or less.12-16 However, appearance and pH of
    aspirates are not sufficiently accurate to distinguish
    between gastric and bronchopulmonary placement."

    "It is difficult to obtain an aspirate from an enteral
    access device when the tip lies in the esophagus. On the
    occasions when an aspirate can be obtained, it is likely
    refluxed gastric juice or swallowed saliva. Thus, observing
    the aspirate's pH and appearance is of little or no
    benefit in this situation. The auscultatory method also
    cannot differentiate between the esophagus and stomach."

    Sorry for bad formatting but I have to get ready for work!

    link to document: