Complications associated with enteral nutrition by nasogastric tube in an internal medicine unit

Abstract

• Enteral nutrition through a nasogastric tube is a technique often used with hospitalized patients when they present problems with oral nutrition. • Patients receiving enteral nutrition show several kinds of complications such as diarrhoea, vomiting, constipation, lung aspiration, tube dislodgement, tube clogging, hyperglycaemia and electrolytic alterations. • We present a prospective and observational study carried out in an Internal Medicine Unit with 64 patients who were fed by a nasogastric tube. From the results it can be seen that older people represented a majority (the average age was 76.2 years), and difficulty in swallowing was the main reason for beginning enteral nutrition. • The complications which appeared were: tube dislodgement (48.5%); electrolytic alterations (45.5%); hyperglycaemia (34.5%); diarrhoea (32.8%); constipation (29.7%); vomiting (20.4%); tube clogging (12.5%); and lung aspiration (3.1%). We discuss the possible relationship between the different factors associated with the enteral nutrition procedure and the occurrence of these complications. • Finally, some nursing interventions are suggested, such as: checking the gastric residue periodically; attempting to place the tube in the duodenum in unconscious patients; and the use of protective mittens in disturbed patients.