Nasogastric Intermittent Suction Management

Indications and Placement

Fine bore (5-8 French gauge) nasogastric tubes should be used for enteral tube feeding unless there is a need for repeated gastric aspiration or administration of high viscosity feeds/drugs via the tube, as recommended by the European Society of Gastrointestinal Endoscopy 1, 2
NG tubes can be placed on the ward by experienced medical or nursing staff, with position checked using pH testing prior to every use, according to the European Society of Gastrointestinal Endoscopy 1

Close monitoring of fluid, glucose, sodium, potassium, magnesium, calcium, and phosphate status is essential in the first few days after initiating enteral tube feeding or when using NG suction, as stated by the European Society of Gastrointestinal Endoscopy 1, 3
Fluid needs can usually be met by giving 30-35 ml/kg body weight, though allowance must be made for excessive losses from drains, fistulae, etc., as recommended by the European Society of Gastrointestinal Endoscopy 4
Maintaining euvolemia with appropriate fluid replacement is crucial when managing patients with NG suction, as emphasized by the American Heart Association 5
Monitoring for electrolyte imbalances is essential when managing patients with NG suction, as stated by the European Society of Gastrointestinal Endoscopy 1, 3

Potential complications of prolonged or excessive NG suctioning include fluid and electrolyte imbalances, as reported by the European Society of Gastrointestinal Endoscopy 1, 3
Nasal erosions, abscess formation, sinusitis, and otitis media from local pressure effects are potential complications of NG suctioning, as noted by the European Society of Gastrointestinal Endoscopy 4
Oesophagitis and ulceration from local abrasion are potential complications of NG suctioning, as reported by the European Society of Gastrointestinal Endoscopy 4