title: A breath of fresh air: a quality-improvement study comparing an air-circulating technique versus conventional technique to prevent nasogastric tube dysfunction.
abstract: BACKGROUND
  Nasogastric tubes are an important component of care in patients with gastrointestinal obstructions. However, they are prone to malfunction despite conventional flushing techniques, with potentially severe consequences. There is no widely accepted, gold-standard way to ensure that a nasogastric tube succeeds in maintaining an empty stomach following flushing.
  
  
  METHODS
  We have developed a flushing technique to better ensure successful tube function. We compared this technique to conventional flushing both in vitro (using a plastic stomach model) and in vivo (in a pig model), and we provide a didactic video.
  
  
  RESULTS
  The mean gastric residual volume following our novel flushing technique is nearly 25-fold lower than following conventional flushing (13 mL vs. 330 mL).
  
  
  CONCLUSIONS
  Our simple technique is more effective than conventional techniques in maintaining nasogastric tube function and therefore should prevent dangerous vomiting and aspiration pneumonia better than conventional techniques.
authors.affiliation: The Department of Surgery, Saint Agnes Hospital, Baltimore, MD USA.
authors.forename: Murad
authors.initials: M
authors.lastname: Bani Hani
authors.affiliation: The Department of Surgery, Saint Agnes Hospital, Baltimore, MD USA.
authors.forename: Ikenna
authors.initials: I
authors.lastname: Ihim
authors.affiliation: The Department of Nursing, Saint Agnes Hospital, Baltimore, MD USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Harps
authors.affiliation: The Department of Surgery, Saint Agnes Hospital, Baltimore, MD USA.|Pancreatic and Hepatobiliary Surgery, Saint Agnes Hospital, 900 Caton Avenue, MB 207, Baltimore, MD 21229 USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Cunningham
keywords: Aspiration; NGT; Nasogastric tube; Patient safety; Pneumonia