Use of flexible video bronchoscope for verification of nasogastric tube position in the intubated patient.

We propose a novel method for verifying the nasogastric tube (NGT) position and tip localization using flexible video bronchoscopy in anesthetized and intubated adult patients. The length of the scope used is 65 cm and can thus, track the NGT up to the pyloric canal. We have used this technique in patients with success. For the prevention of fogging of the scope tip, 2 L/min of oxygen is insufflated through the working channel, which also helps in the opening of the esophagus during endoscopy. Gastric distension due to oxygen insufflation is prevented by repeated suctioning. The course of the NGT can be seen in its entirety in the esophagus and stomach. The esophagus is identified by the pale mucosa and symmetrical delicate folds (Fig. 1a). The stomach is identified by the red mucosa and random tortuous folds (Fig. 1b). The pyloric canal can be identified by the convergence of gastric mucosal folds leading to the pyloric opening (Fig. 1c). In each case, the subdiaphragmatic position of NGT was verified with radiography, which is a routine practice in our institute.