Acute and Critical Care

Gastroenterology
Nasogastric Tube Syndrome: Why Is It Important in the Intensive Care Unit?: Taehyun Kim, Seong Min Kim, Sung Birm Sohn, Yeon Ho Lee, Sang Youn Lim, Jae Kyeom Sim; Korean J Crit Care Med. 2015;30(3):231-233. Published online August 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.3.231

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Although the nasogastric tube (NGT) is widely used in critically ill patients, most intensivists do not give much thought to it or its possible complications. NGT syndrome is a rare but fatal complication characterized by throat pain and vocal cord paralysis in the presence of NGT. Recently, we experienced a case of NGT syndrome developed in an 86-year-old female twelve days after NGT insertion. We immediately removed the NGT and secured the airway by tracheostomy. She was treated successfully with an intravenous antibiotic, steroid and proton pump inhibitor and the syndrome did not recur after reinsertion of the NGT.

Citations

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Nasogastric tube syndrome: A Meta-summary of case reports
Deven Juneja, Prashant Nasa, Gunjan Chanchalani, Ravi Jain
World Journal of Clinical Cases.2024; 12(1): 119. CrossRef

Guidewire-Assisted Nasogastric Tube Insertion in Intubated Patients in an Emergency Center: Jin Go, Hyunjong Kim, Seunghwan Kim, Je Sung You, Min Joung Kim, Hyun Soo Chung, Sung Phil Chung, Hahn Shick Lee; Korean J Crit Care Med. 2013;28(4):287-292.; DOI: https://doi.org/10.4266/kjccm.2013.28.4.287

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Abstract PDF: BACKGROUND
The purpose of this study is to identify the usefulness of guidewire-assisted nasogastric tube insertion in intubated patients with cervical spine immobilization or unstable vital signs in an emergency center.
METHODS
Thirty-four intubated patients in an emergency center were enrolled in the study. Patients were randomly allocated to the control group or the guidewire group. All patient necks were kept in neutral position during the procedure. In the control group, the nasogastric tube was inserted with the conventional method. A guidewire-supporting nasogastric tube was used in the guidewire group. The success rates of the first attempts and overall were recorded along with complications.
RESULTS
The first attempt success rate was 88.2% in the guidewire group compared with 35.2% in the control group (p < 0.001). The overall success rate was 94.2% in the guidewire group and 52.9% in the control group (p = 0.017). Five cases of self-limiting nasal bleeding were reported in the guidewire group, and two cases occurred in the control group. No statistical differences were identified between groups.
CONCLUSIONS
Guidewire-assisted nasogastric tube insertion is a simple and useful method in intubated patients with cervical spine immobilization or unstable vital signs.

Esophageal-Retroesophageal Right Subclavian Artery Fistula: A Case Report: Jin Ho Choi, Chun Sung Byun, Seong Min Kim, Jung Joo Hwang; Korean J Crit Care Med. 2012;27(3):179-181.; DOI: https://doi.org/10.4266/kjccm.2012.27.3.179

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Abstract PDF: Fistula between retroesophageal subclavian artery and esophagus is rare but a fatal complication. The purpose of this case study is to describe a case of 47-year old male presented with intracranial hemorrhage being required a long stay in the intensive care unit and to demonstrate the importance of surveillance patients requiring prolonged nasogastric tube. Recognition of this aberrant artery is critical for the prevention of these catastrophic events.

Nasogastric Tube Insertion using Savary-Gilliard Wire Guide(R) in a Comatose Patient : A Case Report: Hae Jin Lee, Jin Young Chon, Jin Hwan Choi, He Jin Choi, Se Ho Moon; Korean J Crit Care Med. 2006;21(2):135-139.

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Abstract PDF: The insertion of nasogastric tubes in comatose, obtunded or anesthetized patients is often difficult, frustrating and time-consuming. A large variety of methods inserting nasogastric tubes in those uncooperative patients have been reported. As a new effective method, we used Savary-Gilliard Wire Guide(R), which is designed for introducing Savary-Gilliard Dilator(R) into a strictured esophagus, for inserting a nasogastric tube in a comatose patient who was intubated with a ballooned tracheostomy tube. The insertion was successful in the first attempt and no complication occurred.

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