The Impact of Nasogastric Tubes (NGTs) on Swallow Function in Adults with Post-stroke Dysphagia: A Systematic Review.

Seven of the eight studies were rated at moderate or high risk of bias, and the review authors say the findings must be interpreted with caution. Seven of the eight studies assessed the same patients with the tube in and then out, so they can show an association but cannot show the tube caused the difference. The studies used different food and fluid types, volumes from 1 mL to 30 mL, and different assessment methods, and almost none described viscosity in a way that could be compared, so the review could not combine their results. Most studies excluded patients with significant aspiration or with reduced consciousness, so the findings describe people with milder dysphagia and may not apply to the patients most likely to need a tube. Six of the eight studies did not report how dysphagia was diagnosed, only one reported a sample size calculation, and no study reported effect sizes. Only English-language published studies were searched, with no grey literature, and three study teams contacted for missing data did not reply.

The only funder named is the University of Melbourne. No competing interests or other funding are declared in the text.

Do not read this as proof that the tube causes the swallowing impairment, or that removing it will fix things. Seven of the eight studies were observational comparisons of the same patients with and without the tube, so they cannot show cause and effect, and most were judged at moderate to high risk of bias. Most studies also excluded patients with significant aspiration, so the findings describe milder dysphagia and may not apply to your most severely affected patients.