Does Size Matter
August 15, 1999 less than 1 minute read
Does Size Matter?
Source: Ferrer M, et al. Ann Intern Med 1999;130:991-994.
The presence of a nasogastric tube in intubated and mechanically ventilated patients is a significant risk factor in gastroesophageal reflux and microaspiration, but how much does the size of the tube matter? It turns out, maybe not much at all. Despite the commonly held belief that smaller tubes reduce the risk of microaspiration, this study suggests otherwise.
Two different sizes of nasogastric tubes (2.85 mm and 6.0 mm) were placed, in randomized order, in 17 intubated, but clinically stable, patients in an intensive care unit. Pharyngeal aspirates were measured for up to 17 hours after tube placement using radioactive technetium colloid instilled in each patient’s stomach. After 72 hours, the alternate tube was placed and the measurements were repeated. Although the amount of pharyngeal reflux significantly increased over the time the tube remained in place, no difference was observed at any time point between the two tubes, with the possible exception of sinusitis, which was not examined in this study. There does not appear to be much basis for the continued use of these smaller tubes, which are more expensive and generally more difficult to insert than the standard nasogastric tubes.
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