Blind nasogastric tube insertion performed within one minute or for a maximum of three attempts minimize laryngopharyngeal injury during resuscitation

Abstract

Blind nasogastric (NG) is inserted for patients under resuscitation, however minimal trauma to the laryngopharynx can sometimes lead severe bleeding. Recently, NG tube placement under the assistance of a Video-laryngoscope (VLS) has reported. We investigated laryngopharyngeal mucosal injury associated with blind NG tube insertion and considered practical blind NG tube insertion. Patients with cardio pulmonary arrest in whom blind nasogastric tube insertion was possible within 120 s in the Blind group and those in whom it was not possible in the Difficult (Dif) group. In the Dif group, VLS-assisted NG tube insertion was performed. Success rates, insertion time, number and laryngopharyngeal mucosal injury scores were compared. Success rates in the Blind and Dif groups were 98.5% and 76.5%, and insertion times were 48.8 ± 4.0 and 54.8 ± 3.0 s, respectively. The number of insertions and injury scores in the Blind group were significantly lower than those in the Dif group, respectively. The number of insertions and insertion time both showed strong positive correlations with injury scores. Blind NG tube insertion performed within 1 min or for a maximum of two or three attempts may minimize laryngopharyngeal mucosal injury, and VLS-assisted insertion should be considered if these limits are exceeded.