Korean J Crit Care Med.  2015 Aug;30(3):231-233. 10.4266/kjccm.2015.30.3.231.

Nasogastric Tube Syndrome: Why Is It Important in the Intensive Care Unit?

• Kim T
• Kim SM
• Sohn SB
• Lee YH
• Lim SY
• Sim JK

• KMID: 2227656
• DOI: http://doi.org/10.4266/kjccm.2015.30.3.231

Abstract

Although the nasogastric tube (NGT) is widely used in critically ill patients, most intensivists do not give much thought to it or its possible complications. NGT syndrome is a rare but fatal complication characterized by throat pain and vocal cord paralysis in the presence of NGT. Recently, we experienced a case of NGT syndrome developed in an 86-year-old female twelve days after NGT insertion. We immediately removed the NGT and secured the airway by tracheostomy. She was treated successfully with an intravenous antibiotic, steroid and proton pump inhibitor and the syndrome did not recur after reinsertion of the NGT.

Keyword

nasogastric tube; upper airway obstruction; vocal cord paralysis

MeSH Terms

Aged, 80 and over
Critical Illness
Female
Humans
Intensive Care Units*
Critical Care*
Pharynx
Proton Pumps
Tracheostomy
Vocal Cord Paralysis
Proton Pumps

Reference

References

1. McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2009; 33:277–316.

2. Yardley IE, Donaldson LJ. Patient safety matters: reducing the risks of nasogastric tubes. Clin Med. 2010; 10:228–30.

3. Psarras K, Lalountas MA, Symeonidis NG, Baltatzis M, Pavlidis ET, Ballas K, et al. Inadvertent insertion of a nasogastric tube into the brain: case report and review of the literature. Clin Imaging. 2012; 36:587–90.

4. Sofferman RA, Haisch CE, Kirchner JA, Hardin NJ. The nasogastric tube syndrome. Laryngoscope. 1990; 100:962–8.

5. Isozaki E, Tobisawa S, Naito R, Mizutani T, Hayashi H. A variant form of nasogastric tube syndrome. Intern Med. 2005; 44:1286–90.

6. Friedman M, Toriumi DM. Esophageal stethoscope. Another possible cause of vocal cord paralysis. Arch Otolaryngol Head Neck Surg. 1989; 115:95–8.

7. Brousseau VJ, Kost KM. A rare but serious entity: nasogastric tube syndrome. Otolaryngol Head Neck Surg. 2006; 135:677–9.

8. Apostolakis LW, Funk GF, Urdaneta LF, McCulloch TM, Jeyapalan MM. The nasogastric tube syndrome: two case reports and review of the literature. Head Neck. 2001; 23:59–63.

9. Leclerc C, Perhirin M, De Rugy MG, Valdazo A. Severe laryngeal injury due to a nasogastric tube. Ann Fr Anesth Reanim. 2002; 21:306–9.

10. Friedman M, Baim H, Shelton V, Stobnicki M, Chilis T, Ferrara T, et al. Laryngeal injuries secondary to nasogastric tubes. Ann Otol Rhinol Laryngol. 1981; 90(5 Pt 1):469–74.