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Nasogastric tube insertion is performed in the hospital setting for a variety of indications, including enteral feeding. The actual process of nutrients passing through the gastrointestinal (GI) tract appears to stimulate a complex series of responses that affect immunologic integrity. There is a lower incidence of infection, multiorgan failure, and mortality associated with enteral feeding than with total parenteral nutrition (TPN). Feeding tubes will not prevent microaspiration from oropharyngeal contents in cognitively impaired patients (see Table 123-1).

Although relatively simple to perform, it is probably one of the most uncomfortable procedures for the hospitalized patient and carries with it a risk of potentially life-threatening complications. It is crucial to take the necessary steps to ensure patient comfort, obtain a CXR for confirmation of correct placement of the tube, and to take a few simple measures to reduce aspiration risk during enteral feeding (see Table 123-2).

Figure 123-1

Chest radiograph showing properly placed nasogastric feeding tube with tip visible below the diaphragm.

Table 123-1Basic Considerations

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