Deaths associated with insertion of nasogastric tubes for enteral nutrition in the medical intensive care unit: Clinical and autopsy findings

Smith, Avery; Ana, Carol A. Santa; Fordtran, John S.; Guileyardo, Joseph M.

doi:10.1080/08998280.2018.1459400

Cited by 11 publications

(13 citation statements)

References 11 publications

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“…In these cases, artificial feeding through a short‐term enteral access device is common in hospital settings. Although many outcome benefits can be observed in tube‐fed patients, adverse events may occur (Boullata et al., 2017 ) exposing patients to prolonged LOS and greater risk of death (Smith et al., 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with length of stay and death in tube‐fed patients: A cross‐sectional multicentre study

et al. 2021

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Severely ill patients usually present different degrees of inflammation, metabolic stress, comorbidities and haemodynamic instability that can result in reduced calorie and protein intake and increased energy expenditure. There are several reasons why oral ingestion may not be possible in these patients, such as dysphagia secondary to stroke, neuromuscular disease, Parkinson's disease, altered level of consciousness, mechanical ventilation and psychological and/or psychiatric factors, such as anorexia nervosa (Scott & Bowling, 2015). Accordingly, patients who are unable to meet their nutritional requirements may benefit from the use of enteral nu-

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Section: Discussionmentioning

confidence: 99%

Factors associated with length of stay and death in tube‐fed patients: A cross‐sectional multicentre study

et al. 2021

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“…Other studies have reported airway tube misplacements of up to 15% and pneumothorax events of up to 60% due to feeding tube placement 17–21. Adverse outcomes following blind insertions may be more common than has been acknowledged; recently published clinical and autopsy data demonstrate that some deaths assumed to be caused by underlying disease are apparently due to fatal problems with blind insertions 22…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of a novel electromagnetic device for small-bore feeding tube placement

Jacobson

Olayan

Williams

et al. 2019

Trauma Surg Acute Care Open

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BackgroundMisplacement of enteral feeding tubes (EFT) in the lungs is a serious and potentially fatal event. A recent Food and Drug Administration Patient Safety Alert emphasized the need for improved technology for the safe and effective delivery of EFTs.ObjectiveWe investigated the feasibility and safety of ENvue, a novel electromagnetic tracking system (EMTS) to aid qualified operators in the placement of EFT.MethodsThis is a prospective, single-arm study of patients in intensive care units at two US hospitals who required EFTs. The primary outcome was appropriate placement of EFTs without occurrence of guidance-related adverse events (AEs), as confirmed by both EMTS and radiography. Secondary outcomes were reconfirmation of the EFT tip location at a follow-up visit using the EMTS compared with radiography, tube retrograde migration from initial location and AEs.ResultsSixty-five patients were included in the intent-to-treat analysis. EFTs were successfully placed in 57 patients. In eight patients, placement was unsuccessful due to anatomic abnormalities. According to both the EMTS and radiography, no lung placements occurred. No pneumothoraces were reported, nor any guidance-related AEs. Precise agreement of tube tip location was achieved between the EMTS evaluations and radiographs for 56 of the 58 (96.5%) successful placements (one patient had two placements). Tube tip location was re-confirmed 12–49 hours after EFT insertion by the EMTS and radiographs in 48 patients (84%). For 43/48 patients (89.5%), full agreement between the EMTS and radiography evaluations was observed. For the five remaining patients, the misalignment between the evaluations was within the gastrointestinal tract. Retrograde migration from the initial location was observed in 4/49 patients (8%).ConclusionA novel electromagnetic system demonstrated feasibility and safety of real-time and follow-up tracking of EFT placement into the stomach and small intestine, as confirmed by radiographs. No inadvertent placements into the lungs were documented.Level of evidenceLevel V (large case series).

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“…Confirmation of correct enteric tube position within the stomach before use is essential. Introduction of fluids via an enteric tube into the airways can have dire consequences, ranging from aspiration pneumonia, respiratory failure, and death [5]. Therefore, feeding through an enteric tube within the respiratory tract, but not within the oesophagus, is classed as a "never event".…”

Section: Introductionmentioning

confidence: 99%

Automated detection of enteric tubes misplaced in the respiratory tract on chest radiographs using deep learning with two centre validation

Mallon¹,

McNamara²,

Rahmani³

et al. 2022

Clinical Radiology

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Deaths associated with insertion of nasogastric tubes for enteral nutrition in the medical intensive care unit: Clinical and autopsy findings

Cited by 11 publications

References 11 publications

Factors associated with length of stay and death in tube‐fed patients: A cross‐sectional multicentre study

Factors associated with length of stay and death in tube‐fed patients: A cross‐sectional multicentre study

Feasibility and safety of a novel electromagnetic device for small-bore feeding tube placement

Automated detection of enteric tubes misplaced in the respiratory tract on chest radiographs using deep learning with two centre validation

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