Pleuropulmonary Complications of Enteral Tube Feedings

Miller, K. Scott; Tomlinson, James R.; Sahn, Steven A.

doi:10.1378/chest.88.2.230

Cited by 108 publications

(13 citation statements)

References 8 publications

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“…All pleuropulmonary complications were the result of inadvertent passage of tubes into the tracheobronchial tree with eventual perforation into the lung and pleural space. Because the relevant literature [5,6,[9][10][11][12][13] relies on retrospective collections of cases, the exact frequency of nasogastric tube malpositioning in the tracheobronchial tree is difficult to determine. Because the relevant literature [5,6,[9][10][11][12][13] relies on retrospective collections of cases, the exact frequency of nasogastric tube malpositioning in the tracheobronchial tree is difficult to determine.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, air bubbling in the pleura, lung, or esophagus may be transmitted below the diaphragm [9]. Insufflation of air with sounds heard over the region of the stomach should not be ac- cepted as evidence of gastric placement because smallbore tubes do not always allow sufficient passage of air and peristalsis may be mistaken for insufflated air.…”

Section: Discussionmentioning

confidence: 99%

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Radiographic detection of intrabronchial malpositions of nasogastric tubes and subsequent complications in intensive care unit patients

et al. 1997

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radiographic detection of intrabronchial malpositions of nasogastric tubes and subsequent complications in intensive care unit patients

et al. 1997

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“…Pneumonia, pneumothorax, empyema, pulmonary hemorrhage, and death represent the major complications [2]. Pneumothorax is the most common consequence that can be usually treated with chest tube insertion or it can even be healed spontaneously.…”

Section: Discussionmentioning

confidence: 99%

“…This malposition is reported in about 2% of placement attempts with an incidence of major pulmonary complication of 0.7% and mortality of 0.3% of cases [1]. Misplacement in the tracheobronchial tree or in the intrapleural space can cause pneumothorax, pneumonia, empyema, and pulmonary hemorrhage [2]. Most of the cases described in the literature occurred in ICU patients even the in presence of an endotracheal tube with an inflated cuff.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment with one-way endobronchial valve of large air-leakage complicating narrow-bore enteral feeding tube malposition

Giacomo¹,

Venuta²,

Diso³

et al. 2006

European Journal of Cardio-Thoracic Surgery

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Tracheopulmonary intubation is the most common misplacement site for narrow-bore feeding tube and it might be associated with severe pleuro-pulmonary complications. A 38-year-old female with a severe bilateral pneumonia and acute respiratory insufficiency was admitted in the ICU, intubated, and mechanically ventilated. Few hours after the insertion of a narrow-bore feeding tube the patient's oxygen saturation dropped with hypotension and tachycardia. A large left-side hydropneumothorax developed requiring a chest tube. Air-leakage was important and bronchoscopic implant of one-way endobronchial valve was accomplished. Immediate and substantial decrease of air-leakage was observed, and it completely stopped after 5 days; as soon as the patient was extubated. Endobrochial one-way valve, specifically designed for bronchoscopic lung volume reduction, resulted in being safe and effective to control a significant and prolonged air-leakage due to a malposition of a narrow-bore feeding tube.

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“…A small amount of air was visible on the radiograph at the right apex level of this patient. A CT scan shows that the tube is in the major fissure; a small residual pneumothorax is seen in the esophageal recess ral effusion rapidly appearing after initiation of tube feeding, pneumomediastinum, extraesophageal tube portions, mediastinal widening, or mediastinal air±fluid level [21,22]. It should be remembered that the radiograph can fail to disclose a misplaced tube when the film is underexposed or when the tube is only faintly opaque [21].…”

Section: Esophageal Feeding Tubesmentioning

confidence: 99%

Chest roentgenology in the intensive care unit: an overview

1998

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Chest roentgenology in the intensive care unit is a real challenge for the general radiologist. Beyond the basic disease, the critically ill is at risk for developing specific cardiopulmonary disorders, all presenting as chest opacities, their diagnosis often being impossible if based only on the radiological aspect. To make things harder, their appearance can vary with the subject's position and the mechanical ventilation. Patients require a continuous monitoring of the vital functions and their mechanical and pharmacological support, for which they are connected to different instruments. The radiologist should know the normal position of these devices, and promptly recognize when they are misplaced or when complications from their insertion occurred. Our aim is to suggest for each of the above-mentioned conditions a guideline of interpretation based not only on the radiological aspect and distribution of the lesions, but also on the physiopathological and clinical grounds.

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Pleuropulmonary Complications of Enteral Tube Feedings

Cited by 108 publications

References 8 publications

Radiographic detection of intrabronchial malpositions of nasogastric tubes and subsequent complications in intensive care unit patients

Radiographic detection of intrabronchial malpositions of nasogastric tubes and subsequent complications in intensive care unit patients

Successful treatment with one-way endobronchial valve of large air-leakage complicating narrow-bore enteral feeding tube malposition

Chest roentgenology in the intensive care unit: an overview

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