胃管、経鼻胃管、鼻腔チューブ

WordNet

ride or float on an inflated tube; "We tubed down the river on a hot summer day"
conduit consisting of a long hollow object (usually cylindrical) used to hold and conduct objects or liquids or gases (同)tubing
electronic device consisting of a system of electrodes arranged in an evacuated glass or metal envelope (同)vacuum_tube, thermionic vacuum tube, thermionic_tube, electron_tube, thermionic_valve
(anatomy) any hollow cylindrical body structure (同)tube-shaped structure
convey in a tube; "inside Paris, they used to tube mail"
place or enclose in a tube
provide with a tube or insert a tube into
the amount that a tub will hold; "a tub of water" (同)tubful
a large open vessel for holding or storing liquids (同)vat
of a tire; having an inner tube

PrepTutorEJDIC

(金属・ガラス・ゴムなどの)管,筒 / (絵の具・歯みがきなどの)チューブ / 《米》(列車・地下鉄の)トンネル / 《英》地下鉄(《米》subway) / (ラジオ・テレビなどの)真空管(vacuum tube) / (動植物の)管状器官
『おけ』,たらい / 《話》'bath 2 / (また tubful)おけ1杯[の量](の…)《+of+名》 / 《話》のろくてぶかっこうな船;《俗》でぶ,太っちょ
〈U〉管状の物 / 《集合的に》管類 / 〈C〉(ある長さの1本の)管

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/01 12:22:15」(JST)

wiki en

Nasogastric intubation is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose, past the throat, and down into the stomach.

Uses

A nasogastric tube is used for feeding and administering drugs and other oral agents such as activated charcoal. For drugs and for minimal quantities of liquid, a syringe is used for injection into the tube. For continuous feeding, a gravity based system is employed, with the solution placed higher than the patient's stomach. If accrued supervision is required for the feeding, the tube is often connected to an electronic pump which can control and measure the patient's intake and signal any interruption in the feeding.

Nasogastric aspiration (suction) is the process of draining the stomach's contents via the tube. Nasogastric aspiration is mainly used to remove gastric secretions and swallowed air in patients with gastrointestinal obstructions. Nasogastric aspiration can also be used in poisoning situations when a potentially toxic liquid has been ingested, for preparation before surgery under anaesthesia, and to extract samples of gastric liquid for analysis.

If the tube is to be used for continuous drainage, it is usually appended to a collector bag placed below the level of the patient's stomach; gravity empties the stomach's contents. It can also be appended to a suction system, however this method is often restricted to emergency situations, as the constant suction can easily damage the stomach's lining. In non-emergent situations, intermittent suction may be applied giving the benefits of suction without the untoward effects of damage to the stomach lining.

Suction drainage is used for patients who have undergone a pneumonectomy in order to prevent anesthesia-related vomiting and possible aspiration of any stomach contents. Such aspiration would represent a serious risk of complications to patients recovering from this surgery.

Types

Polyurethane NG tube (Viasys Corflo), 8 Fr × 36 in (91 cm). This fine bore tube is appropriate for longer use (up to 4 weeks).

Types of nasogastric tubes include:

Levine catheter, which is a single lumen, small bore NG tube. It is more appropriate for administration of medication or nutrition.^[1]
Salem Sump catheter, which is a large bore NG tube with double lumen. This avails for aspiration in one lumen, and venting in the other to reduce negative pressure and prevent gastric mucosa from being drawn into the catheter.^[1]
Dubhoff tube, which is a small bore NG tube with a weight at the end intended to pull it by gravity during insertion.^[2]

Technique

Before an NG tube is inserted, it must be measured from the tip of the patient's nose, loop around their ear and then down to roughly 5 cm below the xiphoid process. The tube is then marked at this level to ensure that the tube has been inserted far enough into the patient's stomach. Many commercially available stomach and duodenal tubes have several standard depth markings, for example 18" (46 cm), 22" (56 cm), 26" (66 cm) and 30" (76 cm) from distal end; infant feeding tubes often come with 1 cm depth markings. The end of a plastic tube is lubricated (local anesthetic, such as 2% xylocaine gel, may be used; in addition, nasal vasoconstrictor and/or anesthetic spray may be applied before the insertion) and inserted into one of the patient's anterior nares. The tube should be directed straight towards the back of the patient as it moves through the nasal cavity and down into the throat. When the tube enters the oropharynx and glides down the posterior pharyngeal wall, the patient may gag; in this situation the patient, if awake and alert, is asked to mimic swallowing or is given some water to sip through a straw, and the tube continues to be inserted as the patient swallows. Once the tube is past the pharynx and enters the esophagus, it is easily inserted down into the stomach. The tube must then be secured in place to prevent it from moving.

Great care must be taken to ensure that the tube has not passed through the larynx into the trachea and down into the bronchi. To ensure proper placement it is recommended (though not unequivocally confirmed) that injection of air into the tube be performed,^[3] if the air is heard in the stomach with a stethoscope, then the tube is in the correct position. Another more reliable method is to aspirate some fluid from the tube with a syringe. This fluid is then tested with pH paper (note not litmus paper) to determine the acidity of the fluid. If the pH is 5.5 or below then the tube is in the correct position. If this is not possible then correct verification of tube position is obtained with an X-ray of the chest/abdomen. This is the most reliable means of ensuring proper placement of an NG tube.^[4] Future techniques may include measuring the concentration of enzymes such as trypsin, pepsin, and bilirubin to confirm the correct placement of the NG tube. As enzyme testing becomes more practical, allowing measurements to be taken quickly and cheaply at the bedside, this technique may be used in combination with pH testing as an effective, less harmful replacement of X-ray confirmation.^[5] If the tube is to remain in place then a tube position check is recommended before each feed and at least once per day.

Only smaller diameter (12 Fr or less in adults) nasogastric tubes are appropriate for long-term feeding, so as to avoid irritation and erosion of the nasal mucosa. These tubes often have guidewires to facilitate insertion. If feeding is required for a longer period of time, other options, such as placement of a PEG tube, should be considered.

Self-insertion of naso-gastric (NG) tube for home enteral nutrition

Enteral tube feeding can be a source of discomfort, and reluctance from patients. Self-insertion of naso-gastric (NG) tube for home enteral nutrition may be efficacious and well tolerated in patients receiving enteral nutrition for chronic conditions.^[6]

Contraindications

The use of nasogastric intubation is contraindicated in patients with use with base of skull fractures, severe facial fractures especially to the nose and obstructed esophagus, esophageal varices, and/or obstructed airway as well as clotting disorders.

Complications

Minor complications include nose bleeds, sinusitis, and a sore throat.

Sometimes more significant complications occur including erosion of the nose where the tube is anchored, esophageal perforation, pulmonary aspiration, a collapsed lung, or intracranial placement of the tube.

If the NG tube's output appears to be excessive, consider the possibility that it may have been placed in the duodenum.

References

^ ^a ^b Nasogastric Tube. Last authored: Dec 2009, David LaPierre
^ Section 82, Ensure Appropriate Position of the Dubhoff Tube Prior To Feeding. Betsy H. Allbee; Lisa Marcucci; Jeannie S. Garber; Monty Gross, Sheila Lambert, Ricky J. McCraw, Anthony D. Slonim, Teresa A. Slonim (28 March 2012). Avoiding Common Nursing Errors. Lippincott Williams & Wilkins. ISBN 978-1-4511-5324-8. Cite uses deprecated parameters (help)
^ Thomsen TW, Shaffer RW, Setnik GS. (2006). "Videos in clinical medicine. Nasogastric intubation". N Engl J Med 354 (17): e16. doi:10.1056/NEJMvcm050183. PMID 16641390.
^ Thomas B, Cummin D, Falcone RE. (1996). "Accidental pneumothorax from a nasogastric tube". N Engl J Med 335 (17): 1325. doi:10.1056/NEJM199610243351717. PMID 8992337.
^ Cincinnati Children's Hospital Medical Center (2009). "Best evidence statement (BESt). Confirmation of nasogastric tube placement in pediatric patients.". National Guidelines Clearing House: 11.
^ Quilliot, D.; Zallot, C.; Malgras, A.; Germain, A.; Bresler, L.; Ayav, A.; Bigard, M. -A.; Peyrin-Biroulet, L.; Ziegler, O. (2013). "Self-Insertion of a Nasogastric Tube for Home Enteral Nutrition: A Pilot Study". Journal of Parenteral and Enteral Nutrition. doi:10.1177/0148607113502544. PMID 24142673. edit

UpToDate Contents

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English Journal

Fatal surgical or procedure-related complications: a finnish registry-based study.

Hakala T1, Vironen J, Karlsson S, Pajarinen J, Hirvensalo E, Paajanen H.Author information 1Departments of Surgery and Anesthesiology, North Karelia Central Hospital, Tikkamaentie 16, 80201, Joensuu, Finland, tapio.hakala@pkssk.fi.AbstractINTRODUCTION: In Finland, all healthcare personnel must be insured against causing patient injury. The Patient Insurance Centre (PIC) pays compensation in all cases of malpractice and in some cases of infection or other surgical complications. This study aimed to analyze all complaints relating to fatal surgical or other procedure-related errors in Finland during 2006-2010.
World journal of surgery.World J Surg.2014 Apr;38(4):759-64. doi: 10.1007/s00268-013-2364-3.
INTRODUCTION: In Finland, all healthcare personnel must be insured against causing patient injury. The Patient Insurance Centre (PIC) pays compensation in all cases of malpractice and in some cases of infection or other surgical complications. This study aimed to analyze all complaints relating to f
PMID 24271697

Simple Procedure-Serious Problems: Story of a Misplaced Nasogastric Tube.

Gupta V1, Kumar M, Tete PI, Thomas N.
Indian journal of pediatrics.Indian J Pediatr.2014 Mar 16. [Epub ahead of print]
PMID 24633951

[Multicentric study of medical care and practices in spinal muscular atrophy type 1 over two 10-year periods.]

Barnérias C1, Quijano S2, Mayer M3, Estournet B2, Cuisset JM4, Sukno S5, Peudenier S6, Laroche C7, Chabrier S8, Sabouraud P9, Vuillerot C10, Chabrol B11, Halbert C11, Cancès C12, Beze-Beyrie P13, Ledivenah A14, Viallard ML14, Desguerre I15.Author information 1Unité de neuropédiatrie, hôpital Necker enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.2Service de réanimation neuromusculaire, hôpital Raymond-Poincarré, AP-HP, 92380 Garches, France.3Service de neuropédiatrie, hôpital Armand-Trousseau, AP-HP, 75012 Paris, France.4Service de neuropédiatrie, hôpital Jeanne-de-Flandres, 59037 Lille, France.5Hôpital Saint-Vincent-de-Paul, 59020 Lille, France.6Hôpital Morvan, 29609 Brest, France.7Hôpital de la mère et l'enfant, 87000 Limoges, France.8Hôpital Nord, Couple mère-enfant, 42100 Saint-Étienne, France.9Service de neuropédiatrie, American Memorial Hospital, 51092 Reims, France.10Centre hospitalier Lyon Sud, 69310 Pierre-Bénite, France.11Service de neuropédiatrie, hôpital de la Timone, 13005 Marseille, France.12Unité de neuropédiatrie, hôpital des Enfants, 31059 Toulouse, France.13Service de pédiatrie, centre hospitalier de Pau, 64000 Pau, France.14Équipe mobile de soins palliatifs pédiatriques, hôpital Necker enfants malades, AP-HP, 75015 Paris, France.15Unité de neuropédiatrie, hôpital Necker enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France. Electronic address: isabelle.desguerre@nck.aphp.fr.AbstractAIM: Questions about care practices and the role of palliative care in pediatric neurodegenerative diseases have led the Neuromuscular Committee of the French Society of Neurology to conduct a retrospective study in spinal muscular atrophy type 1, a genetic disease most often leading to death before the age of 1 year.
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie.Arch Pediatr.2014 Mar 11. pii: S0929-693X(14)00038-4. doi: 10.1016/j.arcped.2014.01.017. [Epub ahead of print]
AIM: Questions about care practices and the role of palliative care in pediatric neurodegenerative diseases have led the Neuromuscular Committee of the French Society of Neurology to conduct a retrospective study in spinal muscular atrophy type 1, a genetic disease most often leading to death before
PMID 24630620

Japanese Journal

食道挿管を利用した経鼻胃管挿入の一方法

麻酔 65(4), 421-423, 2016-04
NAID 40020808576

Nasogastric tube syndrome induced by an indwelling long intestinal tube

World journal of gastroenterology 22(15), 4057-4061, 2016-04
NAID 120005764016

両側声帯の外転麻痺をきたした経鼻胃管症候群の2症例

日本気管食道科学会会報 = The journal of the Japan Broncho-Esophagological Society 67(4), 289-294, 2016
NAID 40020929632

Related Pictures

★リンクテーブル★

リンク元	「feeding gastrostomy」「経鼻胃管」「胃管」「鼻腔チューブ」「Levine tube」
関連記事	「tube」

「feeding gastrostomy」

Nasogastric intubation
	Intervention
	Stomach tube (Levin type), 18 Fr × 48 in (121 cm)
ICD-9-CM	96.07, 96.6

　　[★]

Surgery A procedure in which an opening is created in the anterior wall of the stomach to allow suction decompression and improved respiratory function by eliminating the need for a nasogastric feeding tube. Cf nasogastric tube.