Incidence of nasogastric tube-related pressure injury in the intensive care unit

Objective: The incidence of medical device-related pressure injuries (MDR-PI) related to nasogastric tubes (NGT) is under-investigated. This is particularly significant in the intensive care unit (ICU), as patients here are highly susceptible to MDR-PI development. This study aimed to undertake continuous surveillance of patients in the ICU to detect NGT-MDR-PI in order to determine its incidence. Method: A prospective cohort study of adult ICU patients with NGT inserted during an ICU stay or shortly before ICU admission, with daily monitoring for NGT-MDR-PI, including documenting the location and stage of any PI detected and excluding patients with facial injuries, wounds or ulcers on admission. Results: One-year data were collected, beginning in July 2022, in the 18-bed general ICU of the Shamir Medical Center (Assaf Harofeh) in Israel (60 patients). NGT-MDR-PI incidence was 5% (3/60). No relationship was found between NGT-MDR-PI development and patients' albumin at admission, age or comorbidities. To the best of the authors' knowledge, this is the first prospective long-term study dedicated solely to NGT-MDR-PI incidence in the ICU. The incidence rate of NGT-MDR-PI was lower than that of endotracheal tube (ETT)-MDR-PI. Conclusion: The difference between NGT-MDR-PI and ETT-MDR-PI incidence rates may lie in the need for strong fixation of the ETT, as accidental ETT removal can be life-threatening. Another reason for the lower NGT-MDR-PI incidence might be the dedicated care of the ICU nursing team, which is responsible for various aspects of PI and wound detection, surveillance and treatment.