“Nasogastric tube versus PEG (Percutaneous Endoscopic Gastrostomy) feeding tubes in ICU: What families in intensive care need to know.”

My name is Patrik Hutzel from intensivecarehotline.com, where we help families of critically ill patients in intensive care to instantly improve their lives by making informed decisions, get peace of mind, control, power, and influence, even if you’re not a doctor or a nurse in intensive care, even if you’re in a situation that you think you can’t have any power, control, or influence, so that your loved one gets best care and treatment always.

Today, I want to talk about a topic that comes up all the time when your loved one is critically ill in intensive care. It’s the topic of feeding tubes. Many families in intensive care ask, “Should my loved one have a nasogastric tube or a percutaneous endoscopic gastrostomy, also known as a PEG tube?” This is not just a technical question. It’s a question that can have a big impact on your loved one’s recovery, comfort, and long-term outcome. So, let’s break this down.

What is a nasogastric tube?

Nasogastric tube is a thin, sometimes also a big one, flexible tube that goes through the nose and down into the stomach. It’s usually used for short-term feeding, often less than 4 weeks. It can be inserted at the bedside and is easy to remove.

What are advantages of a nasogastric tube?

It’s minimally invasive, it’s non-surgical, quick and easy to insert at the bedside, and ideal for short-term use.

What are disadvantages of a nasogastric tube?

It’s very uncomfortable for patients, high risk of complications such as nasal ulceration, sinusitis, aspiration pneumonia, reflux, tube dislodgement, or blockage. It may not be suitable for long-term feeding in some circumstances.

Now, what’s also important to know here is often when patients are going into ICU, especially when it comes to induced comas, they always end up with a nasogastric tube because that’s sort of what you can do quickly, safely; whereas, the PEG tube requires surgery.

So, as much as you want to give patients and families a choice, when it comes to emergency situations, induced comas in ICU, for example, that need to happen right now, part of that is always to insert a nasogastric tube, because that’s quick and easy.

So then, let’s look at, what is a PEG tube?

A PEG tube is inserted directly into the stomach through the abdominal wall with the help of an endoscope. This requires sedation and is more invasive than a nasogastric tube, but it’s generally used for long-term feeding.

So, let’s look at the advantages of a PEG tube.



* More secure and stable for long-term use. Fewer dislodgements and less frequent replacements.

* Lower risk of aspiration pneumonia compared to nasogastric tubes.

* Better long-term nutritional outcomes, particularly beneficial in stroke, brain injury, head and neck cancer patients, but also for anyone that’s got a high spinal injury, long-term ventilation needs with tracheostomy, where a patient cannot be weaned off the ventilator, whether that is from a high spinal injury, whether that is from cerebral palsy, spinal muscular atrophy, and so forth.



Let’s look at disadvantages of a PEG tube.