The Relationship Between the Location of the Nasogastric Tube and Ventilator-Associated Pneumonia in Patients Hospitalized in the Intensive Care Unit

Abstract

Background: It is recommended to start nutrition early in critically ill patients and the preferred method to do so is enteral nutrition which in most cases is achieved by inserting a feeding tube during the first 24 hours. These tubes are placed blindly so the tip of the tube can be placed in different locations. The authors had predicted that placing the tip of the feeding tube in various locations could produce different results in terms of the prevalence of ventilator-associated pneumonia. Methods: We performed this cross-sectional study on 147 patients admitted to the intensive care unit of the Rohani hospital and intubated for at least 5 days receiving enteral feeding via nasogastric (NGT) or gastric tube. Patients were divided into two groups based on the location of the tip of the feeding tube- esophagus or stomach. They were compared in terms of early ventilator-associated pneumonia (VAP) within the first 3-5 days and nasogastric complications such as bleeding, sinusitis and obstruction of the feeding tube. Results: Based on our findings, VAP occurred in 12.2%of the patients. This rate was 9.6% when we placed the nasogastric tube into the stomach and 27.2% when in the esophagus. This difference between the two groups was statistically and clinically significant, while the rate of bleeding, sinusitis and nasogastric tube obstruction was the same between them. Conclusion: The rate of VAP is significantly different when we feed the patients by a nasogastric tube inserted into the stomach (9.6%) and when we do so by placing the tube into the esophagus (27.2%).

Keywords

• ventilator-associated pneumonia
• endotracheal tube
• nasogastric tube