Nasogastric Tubes-Indications, Placement, and Management: A Review

Nasogastric (NG) tube placement is used in a variety of clinical indications. Although there have been few modifications to the tubes themselves, for several decades now the practice and use of NG tubes has continued to evolve. NG tube decompression is one of the tenets of management of small-bowel obstructions that are not complicated by intestinal compromise or peritonitis. Additionally, these tubes are often used following a variety of gastrointestinal surgical procedures. This review provides a comprehensive understanding of the NG tube, the technique for proper placement, indications for use, and related complications.

This review describes the types of NG tubes, indications for use, techniques of placement, and an overview of insertion-related and use-related complications. The essential use of NG tubes for gastric and small-bowel decompression in the setting of obstructions is reviewed, as well as the ever-evolving role for the routine use of NG tubes following gastrointestinal surgery, and the use for prepyloric feeding.

The indications for NG tube placement and management are highly variable and often subjective. Available data inform best practice for the management and use of these tubes in small-bowel obstruction. There is growing evidence that the routine use of NG tubes following elective gastrointestinal surgery can be reduced.