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Pleural Complications of Nasoenteric Feeding Tubes
Author(s) -
Valentine R. James,
Turner William W.
Publication year - 1985
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607185009005605
Subject(s) - medicine , complication , surgery , pneumonia , feeding tube , duodenum , subphrenic abscess , intubation , mechanical ventilation , aspiration pneumonia , intensive care unit , abscess , anesthesia
Pliable, small‐bore, feeding tubes are inserted frequently in critically ill patients. The use of wire stylets to facilitate passage of these tubes has increased the chances of unrecognized tracheal intubations, particularly in obtunded patients. Five patients with depressed sensoria had inadvertent transbronchial insertions of feeding tubes into their pleural spaces over a 28‐month period. The incidence of this complication among intensive care unit patients was 0.3%. Sequellae included pneumothoraces in four patients, pleural effusions in three patients, and pneumonia with a pulmonary abscess in one patient. The presence of cuffed endotracheal tubes did not prevent this complication in patients with depressed cough reflexes. Inexperience of feeding tube insertors may have contributed to pleural intubations in four of the patients. In patients with depressed sensoria, adequate confirmation of feeding tube location in the stomach or duodenum requires both chest and abdominal roentgenograms. ( Journal of Parenteral and Enteral Nutrition 9 :605–607, 1985)