Constriction of an Endotracheal Tube by a Nasogastric Tube During General Anesthesia Resulting in Pulmonary Edema

Lin, Chin-Shuan; Hung, Chih-Jen; Lin, Feng-Sheng; Chan, Wen S.

doi:10.1053/j.jvca.2012.01.045

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…However, if unrecognized a traumatic soft tissue injury is reasonable especially if the removal is through orifices that may not permit the easy extraction of a knotted mass. In one ETT/GT entanglement reported by Lin et al , the coiling of the GT around the ETT was constrictive enough to cause negative pressure pulmonary edema [ 16 ]. The presenting signs were high peak airway pressures, decrease in tidal volumes, and oxygen desaturation to 85%.…”

Section: Resultsmentioning

confidence: 99%

Intraoperative Gastric Tube Intubation: A Summary of Case Studies and Review of the Literature

Long

Machan

Tollinche

2017

OJAnes

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Study Objective Establish complications and risk factors that are associated with blind tube insertion, evaluate the validity of correct placement verification methods, establish the rationales supporting its employment by anesthesia providers, and describe various deployment facilitators described in current literature. Measurements An exhaustive literature review of the databases Medline, CINAHL, Cochrane Collaboration, Scopus, and Google Scholar was performed applying the search terms “gastric tube”, “complications”, “decompression”, “blind insertion”, “perioperative”, “intraoperative” in various order sequences. A five-year limit was applied to limit the number and timeliness of articles selected. Main Results Patients are exposed to potentially serious morbidity and mortality from blindly inserted gastric tubes. Risk factors associated with malposition include blind insertion, the presence of endotracheal tubes, altered sensorium, and previous tube misplacements. Pulmonary aspiration risk prevention remains the only indication for anesthesia-related intraoperative use. There are no singularly effective tools that predict or verify the proper placement of blindly inserted gastric tubes. Current placement facilitation techniques are perpetuated through anecdotal experience and technique variability warrants further study. Conclusion In the absence of aspiration risk factors or the need for surgical decompression in ASA classification I & II patients, a moratorium should be instituted on the elective use of gastric tubes.

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Section: Resultsmentioning

confidence: 99%

Intraoperative Gastric Tube Intubation: A Summary of Case Studies and Review of the Literature

Long

Machan

Tollinche

2017

OJAnes

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“…4 It is clear that the complications of a misplaced NGT can be serious in the case of endobronchial placement, with airway leakage, pulmonary edema, and death among the myriad possibilities. 3,[5][6][7] Methods to detect a malpositioned tube should be undertaken to prevent these sequelae. 6 Traditional practices to verify proper NGT placement include aspiration of gastric contents, auscultation of gastric insufflations, and chest x-ray.…”

Section: Discussionmentioning

confidence: 99%

“…3,[5][6][7] Methods to detect a malpositioned tube should be undertaken to prevent these sequelae. 6 Traditional practices to verify proper NGT placement include aspiration of gastric contents, auscultation of gastric insufflations, and chest x-ray. These methods are not completely reliable, with auscultation falling out of favor for its poor sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery

Kalava¹,

Clark

McIntyre

et al. 2015

Anesthesia Progress

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A 64-year-old male had an awake right nasal fiber-optic intubation with an endotracheal tube for open reduction and internal fixation of bilateral displaced mandibular fractures. After induction of anesthesia, an 18 Fr nasogastric tube (NGT) was inserted through the left nostril and was secured. The patient required high flow rates to deliver adequate tidal volumes with the ventilator. A chest x-ray done in the postanesthesia care unit revealed a malpositioned NGT in the left lower lobe bronchus, which was immediately removed. The patient was extubated on postoperative day 2. Various traditional methods, such as aspiration of gastric contents, auscultation of gastric insufflations, and chest x-ray are in use to detect or prevent the misplacement of an NGT. These methods can be unreliable or impractical. Use of capnography to detect an improperly placed NGT should be considered in the operating room as a simple, cost-effective method with high sensitivity to prevent possibly serious sequelae of an NGT placed within the bronchial tree.

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Constriction of an Endotracheal Tube by a Nasogastric Tube During General Anesthesia Resulting in Pulmonary Edema

Cited by 2 publications

References 6 publications

Intraoperative Gastric Tube Intubation: A Summary of Case Studies and Review of the Literature

Intraoperative Gastric Tube Intubation: A Summary of Case Studies and Review of the Literature

Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery

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