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Incorrect positioning of nasogastric feeding tubes and the development of pneumothorax
J Dobranowski1, J M Fitzgerald, F Baxter
1Department of Radiology, St. Joseph's Hospital, Hamilton, Ont.
Insights
Feeding tubes misplaced into the bronchial tree occurred 14 times in 12 patients, often causing pneumothorax. Proper insertion techniques and radiographic confirmation are crucial for patient safety.
Area of Science:
- Medical Devices
- Patient Safety
- Respiratory Medicine
Background:
- Feeding tube insertion is a common procedure.
- Misplacement into the bronchial tree can lead to serious complications.
- Accurate placement is critical for effective nutritional support and to prevent harm.
Purpose of the Study:
- To report on cases of inadvertent bronchial tree feeding tube placement.
- To highlight the associated complications and outcomes.
- To emphasize the importance of correct placement procedures.
Main Methods:
- Retrospective review of 12 patients with feeding tube misplacements.
- Analysis of the number of misplacements, complications, and outcomes.
- Description of clinical course and management.
Main Results:
- 14 instances of feeding tube misplacement into the bronchial tree were identified in 12 patients.
- Pneumothorax was a frequent complication, occurring in 10 of the 14 misplacements.
- No direct deaths occurred, but one late cardiac arrest was linked to intrapleural feeding.
Conclusions:
- Inadvertent bronchial tree placement of feeding tubes is a significant risk.
- Pneumothorax is a common and serious complication.
- Controlled insertion and radiographic confirmation are essential to minimize feeding tube misplacement risks.
Abstract:
The authors describe 12 patients in whom feeding tubes were inadvertently placed in the bronchial tree a total of 14 times. All but four of the misplacements were complicated by pneumothorax. No deaths were directly attributable to the misplacements, although one cardiac arrest occurred as a late complication of intrapleural feeding. Careful, controlled insertion of feeding tubes and radiographic confirmation of their placement are essential to reduce morbidity and mortality.