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Pneumothorax complicating small-bore feeding tube placement
G D Wendell1, G S Lenchner, R A Promisloff
1Division of Pulmonary Diseases, Hahnemann University Hospital, Philadelphia, Pa. 19102-1192.
Archives of Internal Medicine
|March 1, 1991
Summary
Small-bore feeding tubes can migrate to the lungs, causing pneumothorax. Chest X-rays are essential for confirming correct placement, preventing serious pleural complications.
Area of Science:
- Medical Devices
- Pulmonology
- Gastroenterology
Background:
- Small-bore Silastic feeding tubes are increasingly used for enteral hyperalimentation.
- Traditional methods for verifying nasogastric tube placement are insufficient for these small tubes.
Observation:
- Three cases of feeding tubes migrating into the tracheobronchial tree and pleural space were observed.
- This migration resulted in pneumothorax or hydropneumothorax in affected patients.
Findings:
- A literature review identified 10 similar cases, indicating a non-insignificant incidence of pleural complications.
- Standard placement verification techniques are inadequate for small feeding tubes.
Implications:
- Chest roentgenograms are crucial for confirming accurate gastric placement of feeding tubes.
- Staff education on proper feeding tube insertion techniques can prevent pulmonary complications.
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