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nasogastric tube contraindications

Diana H Liang, Min P Kim, Edward Y Chan, Puja Gaur
Patients with chronic small bowel obstruction and malignant ascites from diffuse peritoneal carcinomatosis have limited options for gastrointestinal decompression as part of end-of-life palliation. Insertion of a percutaneous gastrostomy tube is relatively contraindicated in patients with ascites. Alternatively, nasogastric tube placement often leads to significant discomfort to patients and necessitates hospitalization during their last days of life. Here, we demonstrate how placing a percutaneous cervical esophago-gastric tube can allow adequate gastrointestinal decompression for terminal patients with malignant small bowel obstruction...
January 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Djillali Annane, Christian Brun Buisson, Alain Cariou, Claude Martin, Benoit Misset, Alain Renault, Blandine Lehmann, Valérie Millul, Virginie Maxime, Eric Bellissant
BACKGROUND: We aimed at assessing the benefit-to-risk ratio of activated protein C (drotrecogin-alfa activated, DAA) and corticosteroids, given alone or in combination, in patients with septic shock. METHODS: We implemented an investigator-led, publicly funded, multicenter, randomized according to a 2 × 2 factorial design, placebo-controlled, double-blind trial in four parallel groups in which adults with persistent septic shock and no contraindication to DAA were assigned to either DAA alone (24 mg/kg/h for 96 h), or hydrocortisone (50 mg intravenous bolus q6 for 7 days) and fludrocortisone (50 µg once daily through the nasogastric tube for 7 days) alone, or their respective combinations, or their respective placebos...
December 2016: Annals of Intensive Care
Helene H Flageole, Julia Pemberton
INTRODUCTION: Postoperative emesis commonly affects infants after pyloromyotomy for pyloric stenosis. This randomized controlled trial investigates the impact of preoperative nasogastric tubes (NGTs) on postoperative emesis rate and length of stay (LOS). METHODS: Patients from January 2010 to June 2012 were screened and randomized to have an 8 French NGT or no NGT inserted prior to surgery. Patients contraindicated for NGT or pyloromyotomy, those < 6 months of age, born prematurely, or with cardiac malformations were excluded...
October 2015: Journal of Pediatric Surgery
Gilberto Friedman, Cecilia Lopes Flávia Couto, Maicon Becker
BACKGROUND AND AIMS: Studies comparing jejunal and gastric nutrition show inconsistent results regarding pneumonia. The aim of this study was to evaluate the incidence of pneumonia comparing gastric with jejunal nutrition. Secondarily, we evaluated 28(th) day Intensive Care Unit (ICU) mortality rate and other complications related to enteral feeding. SUBJECTS: Age >18 years; need for enteral nutrition without contraindication for placement of an enteral tube, duration of ICU stay > than 48 h...
February 2015: Indian Journal of Critical Care Medicine
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Marek Szymczak, Anna Chyżyńska, Leszek Hurkała, Emil Płowiecki, Jakub Kmiotek
This report presents the case of an 8.5-year-old boy with Down syndrome after experiencing extensive caustic injury to the oesophagus and stomach resulting from the accidental ingestion of concentrated sulphuric acid. The patient had undergone 32 unsuccessful endoscopic oesophageal stricture dilatations and stenting procedures performed over a period of 15 mo following the accident. Surgical reconstruction of the oesophagus was not possible due to previous gastric and cardiac surgeries for congenital conditions...
April 28, 2014: World Journal of Gastroenterology: WJG
Didier Quilliot, Camille Zallot, Aurélie Malgras, Adeline Germain, Laurent Bresler, Ahmet Ayav, Marc-André Bigard, Laurent Peyrin-Biroulet, Olivier Ziegler
BACKGROUND: Enteral tube feeding can be a source of discomfort and reluctance from patients. We evaluated for the first time the tolerability of self-insertion of a nasogastric (NG) tube for home enteral nutrition (EN). MATERIALS AND METHODS: All patients requiring enteral tube feeding for chronic diseases were enrolled in a therapeutic patient education (TPE) program at Nancy University Hospital. RESULTS: In our department, between November 2008 and August 2012, 66 patients received EN with an NG tube...
September 2014: JPEN. Journal of Parenteral and Enteral Nutrition
Shahzad Iqbal, Jay P Babich, James H Grendell, David M Friedel
Nutritional therapy has an important role in the management of patient with severe acute pancreatitis. This article reviews the endoscopist's approach to manage nutrition in such cases. Enteral feeding has been clearly validated as the preferred route of feeding, and should be started early on admission. Parenteral nutrition should be reserved for patients with contraindications to enteral feeding such as small bowel obstruction. Moreover, nasogastric feeding is safe and as effective as nasojejunal feeding...
December 16, 2012: World Journal of Gastrointestinal Endoscopy
Fritz W Spelsberg, Ralf-Thorsten Hoffmann, Reinhold A Lang, Hauke Winter, Rolf Weidenhagen, Maximilian Reiser, Karl-Walter Jauch, Christoph Trumm
PURPOSE: Percutaneous endoscopic gastrostomy (PEG) or percutaneous endoscopic jejunostomy (PEJ) are substantial for patients with swallowing disorders to maintain enteral nutrition or to decompress palliatively intractable small bowel obstruction. Endoscopic placement can be impossible due to previous (gastric) operation, obesity, hepato-splenomegaly, peritoneal carcinosis, inadequate transillumination, or obstructed passage. Computed tomography (CT)-fluoroscopic guidance with or without endoscopy can enable placement of CT-PG/CT-PJ or CT-PEG/CT-PEJ if endoscopically guided placement fails...
April 2013: Surgical Endoscopy
Michael Fattal, Debra M Suiter, Heather L Warner, Steven B Leder
OBJECTIVE: To determine what effect, if any, the presence or absence of a nasogastric (NG) tube in the same person had on the incidence of anterograde aspiration. DESIGN: Case series with planned data collection. SETTING: Large, urban, tertiary care teaching hospital. SUBJECTS AND METHODS: Referred sample of 62 consecutively enrolled adult inpatients for fiber-optic endoscopic evaluation of swallowing (FEES). Group 1 (n = 21) had either small-bore (n = 13) or large-bore (n = 8) NG tubes already in place and had a FEES first with the NG tube in place and a second FEES after NG tube removal...
November 2011: Otolaryngology—Head and Neck Surgery
Xavier Hébuterne, Geoffroy Vanbiervliet
PURPOSE OF REVIEW: It is usually believed that in case of upper gastrointestinal bleeding patients must be systematically fasted. This review will focus on oral and/or enteral feeding in patients with or at risk of upper gastrointestinal bleeding. RECENT FINDINGS: In case of upper gastrointestinal bleeding, an endoscopy is always required in order to determine the pathophysiology of the bleeding, and in some case to perform an endoscopic treatment. In patients hospitalized in ICU, enteral nutrition is the best stress ulcer prophylaxis...
March 2011: Current Opinion in Clinical Nutrition and Metabolic Care
I Vasile, C Mirea, I D Vîlcea, F Calotă, M Paşalega, C Meşină, M Cheie, S Mogoanţă, T Dumitrescu, C Grecu, V Radu, E Moraru
This paper aim is to discuss the advantages of enteral postoperative feeding on patients submitted to surgery finalized through an eso-digestive anastomosis; in these cases enteral feeding is often delayed 5-8 days after the surgery, and in case of an anastomotic dehiscence may be even impossible. Also, the paper promotes duodenostomy as an important enteral feeding way, and discusses the indications and contraindications of different enteral nutrition pathways in such cases. There were studied 230 cases, 149 cases submitted to cancer surgery and 81 cases with benign condition surgery followed by an eso-digestive anastomosis, in which the following enteral nutrition pathways was practiced: nasogastric or naso-esojejunal feeding tube (55 cases); Witzel jejunostomy (28 cases); gastrostomy (79 cases); duodenostomy (68 cases)...
July 2010: Chirurgia
Kaushik Mukherjee, Michael P Cash, Brian B Burkey, Wendell G Yarbrough, James L Netterville, Willie V Melvin
Total or near-total esophageal stricture results from multiple processes. Traditional treatment with wire cannulation followed by serial dilation is often contraindicated due to poor visualization and the risk of perforation. We seek to demonstrate that combined antegrade and retrograde endoscopy are useful for treatment of total or near-total esophageal strictures. The gastrostomy tube is removed and the tract dilated. A standard endoscope is passed retrograde to the stricture. An antegrade endoscope is advanced until transillumination across the stricture is visualized...
August 2008: American Surgeon
Steven B Leder, Debra M Suiter
OBJECTIVE: To determine what effect, if any, a nasogastric (NG) tube has on occurrence of anterograde aspiration during objective evaluation of swallowing using both liquid and puree bolus consistencies. DESIGN: Prospective, consecutive. SETTING: Large, urban, tertiary care, teaching hospital. PARTICIPANTS: Referred sample of 1260 consecutively enrolled inpatients. Group 1 (n=630; 346 male, 284 female) had an NG tube and group 2 (n=630; 360 male, 270 female) did not have an NG tube at time of referral for dysphagia evaluation...
April 2008: Archives of Physical Medicine and Rehabilitation
Stephen B Hanauer, Arnold Wald
Megacolon, defined as dilation of the abdominal colon, may occur acutely or in a chronic form. Acute megacolon that occurs in association with severe inflammation of the colon is known as toxic megacolon, whereas acute megacolon without obvious colonic disease is known as Ogilvie's syndrome. The pathophysiology and management of toxic megacolon, Ogilvie's syndrome, and chronic megacolon in adults differ significantly, and it is critically important to distinguish among these entities. Toxic megacolon is a medical emergency that requires coordinated intensive medical and surgical management...
June 2007: Current Treatment Options in Gastroenterology
Daniela Baldoli, Flavia Musco, Marco Scalambra, Fabrizio Balsamo, Andrea Galli, Carlo Rebuffat
AIM OF STUDY: To evaluate the outcome of laparoscopic surgery in patients affected by colonic diverticulitis. MATERIALS AND METHODS: A prospective database was established in 1998 at our department to evaluate the results of laparoscopic treatment for diverticular disease. Contraindications to laparoscopic approach were: intestinal obstruction, faecal peritonitis, previuos major abdominal operations, presence of abdominal mass. Parameters evaluated were: indications to operation, age, sex, weight, type of operation, associated operations, operation time, conversion rate, mortality, post-operative complications, postoperative hospital stay, return to normal bowel function, time of removing nasogastric tube and time of restarting oral feeding...
September 2006: Annali Italiani di Chirurgia
I-Chen Wu, Fang-Jung Yu, Jun-Jen Chou, Tzeng-Jih Lin, Han-Wen Chen, Chee-Siong Lee, Deng-Chyang Wu
The aims of this study were to: (1) evaluate the epidemiology of simultaneous upper gastrointestinal bleeding (UGIB) and myocardial injury using parameters including troponin I (TnI); and (2) investigate the predictive risk factors of this syndrome. One hundred and fifty-five patients (101 men, 54 women; mean age, 64.7+/-10.4 years; range, 38-94 years) at the emergency department (ED) with the major diagnosis of UGIB were included. They underwent serial electrocardiography (ECG) and cardiac enzyme follow-up...
January 2007: Kaohsiung Journal of Medical Sciences
Efraim Jaul, Pierre Singer, Ronit Calderon-Margalit
BACKGROUND: Despite the ongoing debate on tube feeding of severely demented patients, the current approach in western countries is to avoid feeding by tube. OBJECTIVES: To assess the clinical course and outcome of demented elderly patients with severe disabilities, by feeding mode. METHODS: The study was conducted in a skilled nursing department of a major psychogeriatric hospital in Israel. Eighty-eight patients aged 79 +/- 9 years were followed for 17 months: 62 were fed by nasogastric tube and 26 were orally fed...
December 2006: Israel Medical Association Journal: IMAJ
Arlene F Tolentino-DelosReyes, Susan D Ruppert, Shyang-Yun Pamela K Shiao
PURPOSE: To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia. METHOD: Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions...
January 2007: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
William N Baskin
Several types of feeding tubes can be placed at a patient's bedside; examples include nasogastric, nasointestinal, gastrostomy, and jejunostomy tubes. Nasoenteral tubes can be placed blindly at bedside or with the assistance of placement devices. Nasoenteric tubes can also be placed via fluoroscopy and endoscopy. Gastrostomy and jejunostomy tubes can be placed using endoscopic techniques. This paper will describe the indications and contraindications for different types of tubes that can be placed at the bedside and complications associated with tube placement...
February 2006: Nutrition in Clinical Practice
Vincent W Vanek
Proper selection of the type of enteral access in a given clinical situation is important to maximize the benefit to the patient and minimize the discomfort to the patient, the morbidity and mortality, and the cost. This decision is based on whether or not the patient needs short-term (<4-6 weeks) or long-term enteral nutrition support. This article focuses on short-term access including nasogastric (NG) and nasoenteric (NE) tubes and reviews each of these enteral access tubes along with their indications, contraindications, advantages, and disadvantages...
October 2002: Nutrition in Clinical Practice
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