NG Tube Suctioning

[Whelan]

Just wondering if anyone has an answer for me as I have been trying to research. Is there any reason for a patient to be on continuous high suction? I was hooking up a patients ng tube today to the wall suction and instinctively put it to low continuous suction and the thought popped into my head. Through my research everything is telling me to only put patients on low continuous suction (and intermittent high suction when necessary) But I'm positive that I had a patient once who had a gastrectomy and was on continuous high suction. Just curious

[Okami_CCRN, BSN, RN]

I was taught by professors and preceptors alike that you do not put patients on high continuous wall suction as the NGT/OGT could be against the gastric wall leading to erosion.

Also low wall suction at 60 should be more than enough to empty the contents of the stomach.

[CalArmy]

I was taught that high suction also can adhere to the wall.

[KatieMI, BSN, MSN, RN]

OK, let's think.

CONTINUOUS suction is needed when: 1) there is a lot of stuff; 2) the stuff is coming out continuously, 3) when the area sucked must be practically empty at all times but organ wall should not be sucked into to avoid ulcers.

Stomach as it is doesn't allow any of these conditions. The baseline secretion (patients on suction are usually NPO) is about 10 cc/min, it is different by areas (less cardia, more pylorus) and due to its shape continuous suction will likely suck out a piece of wall.

Intestinal/duodenal suction, gastrectomy or not, brings out about 30-50 cc/min even if NPO, and a tube is less likely to collapse so the wall would be sucked in.

Gastrectomy usually sucked continiously for a while because the zone of anastomosis behaves more like a bowel while it has to be protected from intestinal juices/increased pressure. Otherwise, docs order this or that type of suction not because "stomach must always be intermittent" but because they know what they want to achieve by suction and which side effects of it they can allow.