1887
  1. Home
  2. A-Z Publications
  3. Qatar Medical Journal
  4. Volume 2010, Issue 2
  5. Article
Volume 2010, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Nasogastric tubes are used in all specialties of medical practice. In critically ill patients, these feeding tubes provide enteral nutrition, which maintains enteric mucosal integrity as well as the immune system of the body, less risk of sepsis and decrease in length of intensive care stay. The insertion of nasogastric tube (NGT) is being considered as a simple blind bedside procedure but this procedure is not free of complications and can be fatal as these tubes can be malpositioned into the respiratory tract or central nervous system. Critically ill patients with endotracheal and tracheostomy tube are at particular risk for malpositioning of the nasogastric tubes due to loss of protective reflexes. Here we report three cases, two intubated and one patient with tracheostomy, in whom the enteral feeding tube was malpositioned into the respiratory system, detected early and a new one inserted in correct position, confirmed by x-ray. The aim of this report is to increase awareness about malpositioning of gastric feeding tubes, proper confirmation of their positioning, risk factors for malpositioning and its prevention.

© 2010 Shaikh, Patil, Mudali, Gafoor, Ummunnisa, licensee Bloomsbury Qatar Foundation Journals.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2010.2.23
2010-12-01
2024-04-20
Loading full text...

Full text loading...

References

  1. Spurrier EJ, Johnston A, Mc Donald D. Use of nasogastric tubes in trauma patients-A review. JR Army Med Corps. 2008; 154::10–13.
     [Google Scholar]
  2. Rombeau JL, Takala J. Summary of round table conference. Gut dysfunction in critical illness. Intensive Care Med. 1997; 23::476–479.
     [Google Scholar]
  3. Rassias AJ, Ball PA, Corwin HL. A prospective study oftrachopulmonary complications associated with the placement of narrow- bore enteral feeding tubes. Critical Care. 1998; 2::25–28.
     [Google Scholar]
  4. Roubenoff R, Ravich WJ. Peumothorax due to nasogastric feeding tubes. Report of four cases, review of literature and recommendations forpreventation. Arch Intern Med. 1989; 149::184–188.
     [Google Scholar]
  5. Duthorn L, Schulte Steinberg H, Hauser H, Neeser G, Pracki P. Accidental intravascular placement of feeding tube. Anesthesiology. 1998; 89::251–253.
     [Google Scholar]
  6. Araujo P, carols E, Melhado ME, Gutierrez EJ, Maniatis J, Casteliano MA. Use of capnometery to verify feeding tube placement. Critical Care. 2002; 30::2255–2259.
     [Google Scholar]
  7. O'Keefe SJD, Foody W, Gill S. Transnasal endoscopic placement of feeding tubes in the intensive care unit. J parenteral and enteral nutrition. 2003; 27::349.
     [Google Scholar]
  8. Benya B, Langer S, Morbarhan S. Flexible nasogastric feeding tube tip immediately after placement. J parenteral and enteral nutrition. 1990; 141::108–109.
     [Google Scholar]
  9. Gregory JA, Turner PJ, Reynolds AF. A complication of nasogastric intubation: Intracranial penetration. J of trauma-injury infection & Critical care. 1978; 18::823–824.
     [Google Scholar]
  10. Metheny NA, Smith L, Stewart BJ. Developmen t of a reliable and valid bedside test for bilirubin and its utility for improving prediction of feeding tube location. Nurs Res. 2000; 49::302–309.
     [Google Scholar]
  11. American association of critical care Nurses practice Alert. Verification of feeding tube placement, May 2005..
  12. Dinsmore RC, Benson JF. Endoscopic removal of a knotted nasogastric tube lodge in posterior nasopharynx. Southern Medical J. 1999; 92::1005–1007.
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2010.2.23
Loading
  • Article Type: Case Report
Keyword(s): enteral feeding, malpositions, Nasogastric tube and X-ray chest

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error