Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2024; 12(1): 119-129
Published online Jan 6, 2024. doi: 10.12998/wjcc.v12.i1.119
Nasogastric tube syndrome: A Meta-summary of case reports
Deven Juneja, Prashant Nasa, Gunjan Chanchalani, Ravi Jain
Deven Juneja, Department of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110017, India
Prashant Nasa, Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
Gunjan Chanchalani, Department of Critical Care Medicine, Karamshibhai Jethabhai Somaiya Hospital and Research Centre, Mumbai 400022, India
Ravi Jain, Department of Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur 302022, Rajasthan, India
Author contributions: Juneja D and Nasa P conceptualized and designed the article; Juneja D, Nasa P, Chanchalani G, and Jain R performed acquisition of data, analysis and interpretation of data, and drafted the article; Chanchalani G and Jain R revised the article; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deven Juneja, DNB, MBBS, Director, Department of Critical Care Medicine, Max Super Speciality Hospital, 1 Press Enclave Road, Saket, New Delhi 110017, India. devenjuneja@gmail.com
Received: October 28, 2023
Peer-review started: October 28, 2023
First decision: December 5, 2023
Revised: December 7, 2023
Accepted: December 18, 2023
Article in press: December 18, 2023
Published online: January 6, 2024
Processing time: 66 Days and 3.7 Hours
ARTICLE HIGHLIGHTS
Research background

The risks associated with nasogastric tube (NGT) placement are often underestimated. Upper airway obstruction with a NGT is an uncommon but potentially life-threatening complication.

Research motivation

NGT syndrome is potentially life–threatening, and early diagnosis is the key to prevention of fatal upper airway obstruction. Lack of specific signs and symptoms and inability to prove temporal relation with NGT insertion, has made diagnosing the syndrome quite challenging.

Research objectives

To review and collate the data from the published case reports and case series, to understand the possible risk factors, early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway obstruction.

Research methods

We conducted a systematic search, from the database of PubMed from all the past studies till August 2023. The search terms included major MESH terms "Nasogastric tube", "Intubation, Gastrointestinal", "Vocal Cord Paralysis", and “Syndrome”. Further, it was filtered for the case reports published in the English language and on adult (> 18 years) humans.

Research results

Twenty-seven cases, from five case series and 13 case reports, of NGT syndrome were retrieved. There was male predominance (62.96%), and the age at presentation ranged from 28 to 86 years. The median time taken for developing symptoms after NGT insertion was 14.5 d (interquartile range 6.25-33.75 d). The most commonly reported reason for NGT insertion was acute stroke (37.01%), and the most commonly reported symptoms were stridor or wheezing (62.96%). The only treatment instituted in most of patients (77.78%) was removing the NGT. The majority (62.96%) of patients required tracheostomy for airway protection, but only three deaths were reported.

Research conclusions

NGT syndrome is an uncommon clinical complication of a very common clinical procedure. Early diagnosis and prompt removal of NGT may suffice in most patients, but a significant proportion of patients presenting with respiratory compromise may require tracheostomy for airway protection.

Research perspectives

A high index of suspicion is required for diagnosis of NGT syndrome. Further studies may aid in identifying the risk factors and help in early diagnosis.