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The Value of a Nasogastric Aspirate

Rafael E. Cuellar, MD; Judith S. Gavaler, PhD; Jeffrey A. Alexander, MD; Douglas E. Brouillette, MD; Mai-Ching Chien, MD; Young-Kul Yoo, MD; Mordechai Rabinovitz, MD; Bradford G. Stone, MD; David H. Van Thiel, MD

Arch Intern Med. 1990;150(7):1381-1384.

Abstract
• A bloody nasogastric aspirate is believed to imply active upper gastrointestinal tract bleeding, while a nonbloody yellowgreen nasogastric aspirate that contains duodenal secretions suggests the absence of bleeding proximal to the ligament of Treitz. To validate these beliefs, physicians were asked to predict the presence of active gastrointestinal tract bleeding and whether bile was present in a nasogastric aspirate obtained immediately before endoscopy in 73 episodes of bleeding in 62 patients. A relationship was found between the physician's assessment of the presence of active bleeding demonstrated endoscopically and the appearance of the nasogastric aspirate. However, the sensitivity and specificity were low (79% and 55%, respectively). No association between the assessment of bile in the nasogastric aspirate and the presence of bile acids was demonstrated. These data do not support the placement of a nasogastric tube to determine whether or not a patient is bleeding, the location of the bleeding, and whether endoscopy should be performed.

(Arch Intern Med. 1990;150:1381-1384)

Author Affiliations
From the Division of Gastroenterology, Department of Medicine, University of Pittsburgh (Pa) School of Medicine (Drs Cuellar, Gavaler, Alexander, Brouillette, Chien, Yoo, Rabinovitz, Stone, and Van Thiel); the Oakland Veterans Administration Medical Center, Pittsburgh (Dr Stone): and the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh (Dr Gavaler).

Footnotes
Accepted for publication December 7,1989.

Reprint requests to 3601 5th Ave, Falk SC, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213 (Dr Van Thiel).

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