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Does the size of nasogastric tubes affect gastroesophageal reflux in children?

N Noviski1, Y B Yehuda, F Serour

  • 1Pediatric Intensive Care, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

Journal of Pediatric Gastroenterology and Nutrition
|October 8, 1999
PubMed

Insights

Larger nasogastric tubes (12-Fr) increase gastroesophageal reflux episodes and acid exposure in children. Smaller tubes (8-Fr) do not significantly alter reflux compared to baseline, suggesting tube size impacts reflux.

Area of Science:

  • Pediatric Gastroenterology
  • Medical Device Research
  • Clinical Trial Analysis

Background:

  • Nasogastric tubes are commonly used in pediatric care.
  • Gastroesophageal reflux (GER) is a concern in infants and children, potentially linked to pulmonary issues.
  • The impact of nasogastric tube size on GER requires further investigation.

Purpose of the Study:

  • To evaluate the effect of nasogastric tube insertion on gastroesophageal reflux in children.
  • To determine if different nasogastric tube sizes influence the incidence and severity of GER.

Main Methods:

  • Prospective randomized study involving 29 children (1 month to 4 years).
  • 24-hour esophageal pH monitoring was performed.
  • Comparison of reflux parameters (NREs, NRE>5, PTP<4) during baseline, 8-Fr, 10-Fr, and 12-Fr nasogastric tube use.

Main Results:

  • The 12-Fr nasogastric tube group showed a significant increase in reflux episodes lasting over 5 minutes (NRE>5) and percentage of time with esophageal pH < 4 (PTP<4) compared to baseline and the 8-Fr group.
  • No significant differences in reflux parameters were observed between the 8-Fr and 10-Fr groups, or between the 10-Fr group and baseline.
  • These findings were consistent in children with and without pre-existing GER.

Conclusions:

  • The size of the nasogastric tube is a significant factor in pediatric gastroesophageal reflux.
  • Larger nasogastric tubes (12-Fr) appear to impede the esophageal clearance of refluxed acid.
  • Smaller nasogastric tubes (8-Fr, 10-Fr) did not demonstrate a significant impact on GER compared to baseline.
Abstract

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