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What size OG tube for decompression

NICU   (2,346 Views | 6 Replies)
by tjnkjn99 tjnkjn99 (New) New

526 Profile Views; 5 Posts

I have recently started travel nursing after being in a unit for 20 years. I am being introduced to many new ideas and practices which I question. So my first interaction with another travel nurse was one of disagreeing about the size of OG tube to use on a 1000gm infant that was not tolerating feedings and had a huge distended abdomen. On xray the stomache and intestine were filled with air. I put in an#8 F OG tube and was immediately told to take it out because it was too big and the otehr nurse had never ever used an 8F on a 1000gm baby. It has been my experience when needing to decompress the stomache we used an 8F OG tube. That was what the neo wanted in. What is common for other units..

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walkingrock has 41 years experience as a ADN and specializes in Retired NICU.

172 Posts; 5,428 Profile Views

8fr

Is standard

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Baby Wrangler specializes in NICU.

51 Posts; 1,942 Profile Views

On my unit, we usually use 8 Fr too for decompression but those babies tend to be placed NPO already, for NEC watch, etc. If we think it's just a huge cpap belly and we're still continuing feeds we put in a 6 Fr. I imagine if you're feeding through an 8Fr, the feed would go down way too fast.

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TiffyRN has 27 years experience as a ADN, BSN, PhD and specializes in NICU.

2,306 Posts; 16,399 Profile Views

I once had a Neo stand over a little one (I think around 800g) with a huge belly (probably CPAP belly but we were on NEC watch at the time) and ask, can we put a larger Replogle in? I told him I had already put the 8F in, did he want me to go get the 10? He's like. . . "I guess not. . . "

We use BCPAP extensively and though our guidelines call for 5 or 6.5F for less than 1250g, if they are on BCPAP, they may start with the guideline recommended tube, but in no time, there will be an 8F down. If we can keep them decompressed and off the vent, that 8F is a heck of a lot less invasive or huge as an ETT.

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prmenrs has 42 years experience as a RN and specializes in NICU, Infection Control.

2 Followers; 4,565 Posts; 32,843 Profile Views

I think a 10F Repogle (inserted orally) is reasonable for decompression if you're suspecting NEC. An 8 Feeding tube is ok as a "vent" for CPAP. but if the baby is distended, I might go for the larger tube, @ least for a while.

Soak it in warm water 1st to soften it for insertion. Some are so stiff, they could be uncomfortable.

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95 Posts; 2,747 Profile Views

I find that a 5F just doesn't decompress the stomach so I use an 8F whenever possible. I'm not sure our unit actually has a specific protocol.

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FlyingScot has 28 years experience as a RN and specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

2,016 Posts; 21,906 Profile Views

10fr Andersen. Best tubes I have ever worked with. Pliable and vented.

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