A nasogastric tube (NGT) is a flexible tube that is passed through the nose, down the oesophagus, and into the stomach. Generally used for enteral feeding and/or gastric drainage, NGTs offer a minimally invasive and usually well-tolerated solution by patients. However, they differ in their intended use, type of connector, material, size, and length. This article presents the key features of NGTs and provides guidance on NGT selection.
NGTs are used to provide enteral nutrition, water and medication directly into the patient’s stomach or small intestine.
NGTs can also be used for gastric drainage, which involves emptying all or part of the stomach contents. Gastric drainage alleviates bloating and symptoms associated with delayed gastric emptying as well as providing gastric secretions for diagnostic procedures1.
The intended use of an NGT influences a number of parameters, including the type of connector, number of lumens and tube material
Available as a single- or double-lumen NGT. Requires funnel connectors.
Single-lumen NGT with ENFit connectors. Drainage is also possible with an ENFit syringe.
Available with up to three lumens and multiple ports. Compatible with ENFit and funnel connectors to allow feeding and drainage through the same tube.
The connectors on the tube determine its compatibility with other medical devices such as with administration sets, syringes and accessories. These connectors, called small bore connectors, link and seal delivery systems together.
Patients may be connected to several delivery systems at once, such as an enteral feeding system, intravenous (IV) line, tracheostomy tube or peritoneal catheter. However, the legacy connectors are universal and compatible between one another, meaning that a medical device for one delivery system can be accidentally connected to a system designed for a different function. Such misconnections may put patients at risk and in some cases can be life-threatening. Given this risk, a global standard connector named ENFit was developed to promote safe and optimal delivery of enteral feeding.
The most widely used connector in multiple delivery systems. It allows different types of medical devices to be connected, thereby creating a risk of misconnection2.
Compatible with drainage or aspiration systems. Drainage tubes use a funnel connector which may also be compatible with the ENLock connectors prevalent in older enteral feeding tubes.
The ENLock predates the ENFit industry standard. It is incompatible with IV systems but compatible with some drainage and aspiration connectors.
The universal system for tube diameter is the French gauge (Fr), also known as the Charrière scale (Ch). The larger the Fr, the wider the external diameter of the tube. Each Fr increment equals 0.33 mm in diameter. NGTs typically range from 3.5 Fr3 for neonates to 14 Fr for adults and up to 24 Fr for triple-lumen gastric feeding/drainage tubes2.
Small-bore tubes (< 12 Fr) help to improve patient comfort and reduce the risk of tube feeding complications including rhinitis, oesophageal reflux, oesophagitis and oesophageal stricture. A small-bore tube should therefore be preferred where possible3.
It should also be noted that tubes between 8 Fr and 12 Fr are generally for feeding, whereas larger ones (> 12 Fr) are for drainage as their larger lumen is less likely to clog2.
PVC, silicone and polyurethane are the most common materials for NGTs. This variety allows to meet a a range of indications, offering greater flexibility.
NGTs are available in lengths of 90 to 165 cm for adults, or shorter for paediatric patients. Their length depends also on the tube’s placement site:
NGT complications can be associated with tube insertion and tube care. The risk of complications can be minimised by employing appropriate preventative steps. Some of these include:
Watch the Compat Soft video to learn more about NG tube placement and daily care.