Complications of nasoenteric feeding tubes

Capnography confirms correct feeding tube placement in intensive care unit patients

“…[1][2][3][4][5][6][7][8][9][10] Unfortunately, complications may have occurred by the time a radiograph is obtained with this approach. Feeding tubes are normally passed to a depth of 50-80 cm in order to reach the desired gastric or small bowel location.…”

“…9 Case reports of this scenario with subsequent pneumothorax are readily found in the literature. 4,5,7,10 Other techniques to determine if the tube tip is in the lung, stomach, or small bowel have been described. These include pH testing or visual inspection of tube aspirates, insufflation of air via the tube while auscultating over the epigastrium, listening for air movement at the tube's proximal end, observing for bubbling when the proximal tube end is held underwater, and utilizing pressure manometry attached to the tube.…”

Down the Wrong Way: An Important Complication of Nasogastric Tube Placement

“…With concern that this could be a sign indicating a pulmonary tree tear or esophageal tear/rupture, a computed tomography (CT) scan of the thorax was performed. Perforation and dissection of the esophagus have been reported in the literature [1]. CT of thorax did not show any evidence of esophageal or tracheobronchial tear.…”

Initial and Ongoing Verification of Feeding Tube Placement in Adults (applies to blind insertions and placements with an electromagnetic device)

“…55,56 Radiographic Confirmation 1. A properly obtained and interpreted radiograph is recommended to confirm correct placement of any blindly inserted tube (small bore or large bore) before its initial use for feedings or medication administration 1,11,[57][58][59][60][61][62][63] ; the same recommendation applies to a tube inserted with assistance from ETP device. 52,53 Because radiographs may be misinterpreted, 39,45,58,64 it is best to have a radiologist interpret the film to approve use of the tube for feedings.…”