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Updated: Aug 7, 2026
07:34
Ultrasonography-Guided Nasogastric Tube Placement and Verification: A Standardized Nursing Protocol
Published on: April 7, 2026
Lung perforation by nasogastric feeding tubes
W Druml1, G Kleinberger, W Base
11st Department of Medicine, University of Vienna, Vienna, Austria.
Clinical Nutrition (Edinburgh, Scotland)
|March 1, 1984
Summary
Misplaced nasogastric feeding tubes can cause lung perforation and pleural effusion in intensive care patients. Always confirm tube placement with imaging to prevent serious complications.
Area of Science:
- Medicine
- Critical Care Medicine
- Gastroenterology
Background:
- Nasogastric feeding tubes are commonly used in intensive care units.
- Incorrect placement of these tubes can lead to severe complications.
- Existing methods for confirming placement may not be entirely reliable.
Purpose of the Study:
- To report cases of endotracheal misplacement of narrow bore nasogastric feeding tubes.
- To highlight the potential for lung and gastrointestinal tract perforation.
- To emphasize the need for improved methods to confirm correct tube placement.
Main Methods:
- Case report of two intensive care patients with feeding tube misplacement.
- Review of insertion procedures and confirmation methods used.
- Analysis of complications including pneumothorax and hydrothorax.
Main Results:
- Two patients experienced lung perforation and pleural effusion due to endotracheal tube misplacement.
- Aspiration of pleural effusion was misinterpreted as gastric contents.
- Auscultation for gurgling sounds proved unreliable for confirming intragastric placement.
Conclusions:
- Endotracheal misplacement of feeding tubes is a significant risk in intubated, sedated patients.
- Relying solely on aspiration or auscultation for placement confirmation is dangerous.
- Mandatory radiographic confirmation of tube placement is essential to prevent life-threatening complications.
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