Gastric decompression in respiratory distress

elizabells, BSN, RN · Nov 5, 2008

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.

busyrn62 · Nov 5, 2008

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?

elizabells, BSN, RN · Nov 5, 2008

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.

Jolie, BSN · Nov 6, 2008

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.

elizabells, BSN, RN · Nov 6, 2008

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

NicuGal, MSN, RN · Nov 7, 2008

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

barbnicu · Jul 9, 2009

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 1501 grams. Has anyone come across any literature to support these recomendations?

texas2007, BSN, RN · Jul 10, 2009

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 1501 grams. Has anyone come across any literature to support these recomendations?

Your

dawngloves, BSN, RN · Jul 12, 2009

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 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.

barbnicu · Jul 13, 2009

Thanks to everyone who got back to me. It is our standard of care to place an OG to vent for infants with resp. diffulculty, no matter what the gestational age. Especially if they are on Vapotherm, or Nasal cannula. I agree with that, they are going to inflate their little stomachs quickly, and that can just create more resp. distress. The question was: is there evidence to support this practice? Esp. with the weight parameters: OG to low inter. sx 1501 grams.

If I can't come up with written evidence, the neo. will just have to make it a standing order, and it won't be written into the System Policy (I am on the policy committee)