A manometry-guided technique to facilitate insertion of a nasogastric tube in intubated, mechanically ventilated patients

Placement of a nasogastric tube (NGT) is sometimes difficult in clinical practice, especially in intubated, mechanically ventilated patients. The purpose of this preliminary study was to investigate whether use of a manometer to obtain pressure readings during NGT insertion in intubated, mechanically ventilated patients improved insertion success rates compared with traditional blind insertion technique. A total of 40 adult patients who underwent elective open abdominal surgery and required gastric decompression were randomly allocated to either blind insertion group (n = 20) or manometry-guided group (n = 20). In the blind insertion group, NGTs were inserted blindly as usual manner. In the manometry-guided group, NGTs were inserted according to the pressure readings on a manometer to adjust its movement. Successful placement of a NGT was confirmed by using a fiberscope. Insertion of a NGT was successful at the first attempt more frequently in the manometry-guided group than in the blind insertion group (100% vs 70%; P = 0.02). In conclusion, use of a manometer to obtain pressure readings during NGT insertion can facilitate NGT insertion in intubated, mechanically ventilated patients.