Understanding the Nasogastric Tube
A nasogastric (NG) tube is a flexible tube inserted through the nose, down the esophagus, and into the stomach for temporary access [1.2]. They are used for various medical interventions including feeding, medication administration, or removing stomach contents [1]. Different NG tubes exist, varying by size (measured in French units), material, and the number of lumens. Selection depends on patient anatomy, intended use, and duration [2].
The Most Common NG Tubes
Among the various types, the Salem Sump and Levin tubes are the most frequently used due to their distinct features and versatility.
The Salem Sump Tube
The Salem Sump is widely used for gastric suction. It has a double lumen: a large one for aspiration and a smaller air vent (the 'pigtail' with a blue port) [1.2]. This vent prevents suction from damaging the stomach lining, making it suitable for continuous removal of gastric contents and air [1.2]. It's often used for postoperative decompression, bowel obstructions, or managing gastric bleeding [1.2]. The clear plastic allows observation of the drained contents [1.2].
The Levin Tube
The Levin tube has a single lumen and is used for intermittent feeding, medication, or aspiration when less powerful suction is needed [1.2]. Its single channel can make it more prone to suctioning against the stomach wall [2]. Made from rubber or plastic, it's a reliable, cost-effective option for short-term use, especially when continuous suction isn't required [2].
Comparison of Common Nasogastric Tubes
Here is a comparison of key features of common NG tubes:
| Feature | Salem Sump Tube | Levin Tube | Dobhoff Tube |
|---|---|---|---|
| Lumen Type | Double (suction & vent) [1.2] | Single [1.2] | Single, small-bore [2] |
| Primary Use | Continuous gastric decompression [1.2] | Intermittent suction, medication, feeding [1.2] | Long-term enteral feeding [2] |
| Material | Clear plastic [1.2] | Rubber or plastic [2] | Polyurethane or silicone [2] |
| Sump Port | Yes (blue 'pigtail') [1.2] | No [1.2] | No [2] |
| Insertion | Standard bedside [3] | Standard bedside [3] | Often requires guide wire [2] |
| Patient Comfort | Potential mucosal irritation [1.2] | Higher risk of mucosal irritation with suction [2] | High (for long-term use) [2] |
Selecting the Right Tube for the Job
Tube selection depends on the patient's needs [2]. A Salem Sump might be used for continuous drainage after abdominal surgery, while a Levin tube could be for temporary feeding [2]. For long-term feeding with aspiration risk, a Dobhoff tube, which can be placed past the stomach into the small intestine, might be considered [2].
Beyond the Stomach: Other Enteral Access Tubes
NG tubes are part of a larger group of enteral access devices. Other options include nasojejunal (NJ) tubes for access to the small intestine, and gastrostomy (G) or jejunostomy (J) tubes placed surgically through the abdominal wall for longer-term feeding [2].
Insertion, Verification, and Safety Measures
Inserting an NG tube involves a standardized procedure to measure, lubricate, and advance the tube, ensuring patient comfort [3]. Proper placement is crucial to avoid complications like insertion into the airway [3]. Verification involves checking the pH of aspirated fluid (should be acidic in the stomach) and, for definitive confirmation before first use, a chest X-ray [3]. Ongoing monitoring is needed to prevent dislodgement or blockage. For more information on safety, the Agency for Healthcare Research and Quality (AHRQ) is a valuable resource.
Conclusion
The Salem Sump and Levin tubes are key types of nasogastric tubes, each serving distinct purposes. The Salem Sump's double lumen aids continuous suction, while the Levin's single lumen is suitable for intermittent use and feeding [1.2]. Understanding these differences and ensuring correct placement and monitoring are essential for patient safety and effective care [3].
