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Insertion de la sonde nasogastrique

BACKGROUND: It is often difficult to correctly place nasogastric (NG) tubes under
anesthesia. We hypothesized that simple modifications in technique of NG tube
insertion will improve the success rate.
METHODS: Two hundred patients were enrolled into the study. The patients were
randomized into four groups: control, guidewire, slit endotracheal tube, and neck
flexion with lateral neck pressure. The starting point of the procedure was the time
when NG tube insertion was begun through the selected nostril. The end point was
the time when there was either a successful insertion of the NG tube or a failure
after two attempts. The success rate of the technique, duration of insertion
procedure, and the occurrence of complications (bleeding, coiling, kinking, and
knotting, etc.) were noted. 2, analysis of variance, and Student’s t-test were used
to analyze the data.
RESULTS: Success rates were higher in all intervention groups compared with the
control group. The time necessary to insert the NG tube was significantly longer in
the slit endotracheal tube group. Kinking of the NG tube and bleeding were the
most common complications.
CONCLUSION: The success rate of NG tube insertion can be increased by using a
ureteral guidewire as stylet, a slit endotracheal tube as an introducer, or head
flexion with lateral neck pressure. Head flexion with lateral neck pressure is the
easiest technique that has a high success rate and fewest complications.Cliquez


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Management of difficult airway patients and the use of a difficult airway registry at a tertiary care pediatric hospital. Sheeran PW ,  Walsh BK ,  Finley AM ,  Martin AK ,  Brenski AC . Author information Abstract BACKGROUND: Appropriate recognition and management of the pediatric difficult airway is essential. Two patient deaths in a 2-year period involving children with a known difficult airway led to the formation of the institution's multidisciplinary Difficult Airway Committee. METHODS: Patients with a suspected difficult airway or a known difficult airway are entered into a registry of difficult airway patients. A note describing the airway and any experiences at airway manipulation is entered as part of a difficult airway note in the patient's electronic medical record as soon as the patient is recognized as having a difficult airway. A call system has been developed to mobilize expert emergency airway assistance for these patients. Multi...