by busyrn62

In our unit it is standard to insert an OG/NG tube in neonates that have respiratory distress for gastric decompression. Does anyone else have this standard? Is there evidence to support this practice?

Re: Gastric decompression in respiratory distress

We are expected to (although sometime people don't) insert a short 8Fr OGT in all kids on CPAP to vent and aspirate the stomach. The continuous pressure pumps air into the stomach. All CDH kids get a Replogle to LWS as well. Mmm, I think kids who are paralyzed are also supposed to get a Replogle to LWS, but that doesn't always happen.

It makes sense to me. There's not a lot of room in there, so venting/decompressing the stomach creates more space for the lungs to expand.

Re: Gastric decompression in respiratory distress

I agree for infants on CPAP or even a high flow cannula where air is being forced into the esophagus as well as the lungs, but how about those in respiratory distress not on ventilatory support?

Re: Gastric decompression in respiratory distress

Originally Posted by busyrn62

how about those in respiratory distress not on ventilatory support?

... does not compute. Our kids go straight on CPAP at the first grunt, flare, or pull.

Re: Gastric decompression in respiratory distress

Originally Posted by busyrn62

I agree for infants on CPAP or even a high flow cannula where air is being forced into the esophagus as well as the lungs, but how about those in respiratory distress not on ventilatory support?

Babies who are under a hood with tachypnea, nasal flaring, grunting and/or retractions need their tummies decompressed as well. Their breathing is anything but efficient, and they pull a lot of air into their tummies. Just look at a CXR of a kid with TTN or mild RDS and you will likely see a distended stomach as well as air in the intestines.

Re: Gastric decompression in respiratory distress

Ahh, gotcha. We don't use hoods, so I didn't even think of it.

Re: Gastric decompression in respiratory distress

All resp distress kids get an og/ng for decompression, esp ones not intubated.

Re: Gastric decompression in respiratory distress

The decompression horse is not dead yet. I need to find EVIDENCE for placing a tube to decompress the stomach of a neonate on Vapotherm. My Neo doc. wants a #8F OG to low intermittant suction for infant <1500 gm, and and #8 OG open to air to vent stomach of >1501 grams. Has anyone come across any literature to support these recomendations?

Re: Gastric decompression in respiratory distress

Originally Posted by barbnicu

The decompression horse is not dead yet. I need to find EVIDENCE for placing a tube to decompress the stomach of a neonate on Vapotherm. My Neo doc. wants a #8F OG to low intermittant suction for infant <1500 gm, and and #8 OG open to air to vent stomach of >1501 grams. Has anyone come across any literature to support these recomendations?

Your <1500 g aren't eating?

Re: Gastric decompression in respiratory distress

Originally Posted by barbnicu

The decompression horse is not dead yet. I need to find EVIDENCE for placing a tube to decompress the stomach of a neonate on Vapotherm. My Neo doc. wants a #8F OG to low intermittant suction for infant <1500 gm, and and #8 OG open to air to vent stomach of >1501 grams. Has anyone come across any literature to support these recomendations?

I'm going to guess you mean those new admit, NPO kiddos.
I remember in the "old" day we would do that with the term, TTN like kids. I really don't remember it helping. We don't do it anymore. Not sure why. Maybe because it didn't help? Whis I could help you with an article or something.