Naogastric tube

[tkyeung]

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?

[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For example, fluid withdrawn from a tube that has perforated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: http://pen.sagepub.com/content/early/2009/01/27/0148607108330314.full.pdf+html