Sick neonates often need gastric decompression and various decompression tubes are used. However, on the roentgenograms after tube placement, we noticed the proximal vent hole often is not in the stomach and may even be in the glottis, thus not allowing for efficient decompression and posing a risk of aspiration of any fluids in the tube. We studied three types of tubes often used for gastric decompression, the 10F feeding tube, 10F Salem sump tube and 10F Replogle suction catheter. Retrospectively, roentgenograms of 39 neonates weighing between 0.5 and 4.0 kg, in 0.5 kg increments, were studied to determine the “correct fit” of the tube. The “correct fit” is with the tube placed on top of the roentgenogram, the tip of the tube is positioned correctly in the stomach at the level of the 3rd lumbar vertebra and all of the tube vent holes are at or below the level of the 12th thoracic vertebra which corresponds to the stomach cardia. The table shows the “correct fit” assessment.

Table 1 No caption available.
Full size table

The feeding tube with it's single hole and lumen is not suitable for efficient gastric decompression, being prone to blockage and tissue damage. The double lumen Salem sump tube, more practical and safer, did not permit all vent holes to be within the stomach of even the largest neonate. This is not efficient and risks aspiration. The double lumen Replogle suction catheter however, with close proximity of all the vent holes, has them all within the stomach of even the smallest neonate and should be best and safest for gastric decompression.