Figure 3. Key features of the subcategory respiratory complications described in included articles. Ribeirão Preto, SP, Brazil, 2018.
| Article Number |
Study Aim | Study Type | Main Results |
|---|---|---|---|
| 1 | To investigate the rate of VAP* and adequacy of nutrient delivery with gastric vs small intestinal feeding. | Prospective, randomized, controlled trial | ICU† patients were observed for a period of 15 months. All patients needed mechanical ventilation and enteral nutrition. After tube insertion, all patients underwent radiography to confirm tube placement. Aspiration or VAP* was confirmed between patients with NGT‡ and NET§, but the difference was not significant. |
| 2 | To describe the management of patients treated with enteral nutrition and to identify complications and mortality. | Prospective observational study | From 108 patients included in the study, 45 used NET§, 62 used gastrostomy and one patient had jejunostomy. The following complications were observed: aspiration (15%); accidental removal (62%) and tube obstruction (11%). The mortality rate was 23% at one year and the average survival was 674 days. |
| 3 | To compare the outcomes of ICU† patients fed through an NGT‡ vs. a nasal-small-bowel tube including the time from tube placement to feeding, time to reach goal rate, and adverse events. | Prospective randomized study | Sixty patients were randomized to receive gastric or small-bowel tube feedings. Adverse outcomes included witnessed aspiration, vomiting, and clinical/radiographic evidence of aspiration. There was no difference in aspiration events within groups. |
| 4 | To determine the type and incidence of pulmonary complications associated with the placement of narrow-bore enteral feeding tubes. | Prospective observational study | 740 tubes were inserted and 14 cases (2%) of tube misplacement to the trachea and bronchi were identified. In all patients, auscultation was positive for rustling sounds, but radiography identified the incorrect positioning of the tip. Five patients suffered severe complications (pneumothorax) and two died. |
| 5 | To investigate the prevalence rate and influencing factors of pneumonia associated with long-term feeding in special care units for patients with persistent vegetative states (PVS). | Prospective observational study | Two hundred sixty subjects were chosen from three hospital-based special care units for patients with PVS and 10 nursing facilities for persons in PVS in Taiwan. Data were collected through chart review and observations. The factors associated with pneumonia were: length of hospital stay and enteral nutrition. |
| 6 | To report the case of 14 patients who had inadvertent tube misplacement, resulting in complications that included pneumothorax, empyema, mediastinitis, pneumonia, and esophageal perforation. | Retrospective observational study | Fourteen patients with a misplaced tube were selected over a period of 18 months. Of the 13 patients who had pulmonary complications, one had received enteral nutrition before confirmation by X-ray. Complications included pneumothorax, that required pleural drainage, and esophageal perforation. |
| 7 | To illustrate the radiographic spectrum of the intrabronchial malposition of gastric tubes and subsequent complications, and to discuss the role of radiography in the detection of such malposition. | Retrospective observational study | Over a period of 11 months, 14 cases of tube misplacement were recorded in the tracheobronchial tree. Of the 14 insertions, eight were performed blindly at the bedside and six by laryngoscope. Nine tubes were inserted in the right tracheobronchial tree and five in the left. Four patients had pleural perforation, with consequent pneumothorax and need for chest tube insertion. Another four patients developed pneumonia. |
| 8 | To determine whether a specialized feeding tube placement team had a beneficial effect on procedure-related pneumothorax. | Retrospective observational study | Over a three-year period, researchers analyzed reports of NET§ displacement to the tracheobronchial tree. Of the 4,190 patients included, 683 had respiratory adverse events associated with the tube; of these, nine suffered pneumothorax. |
| 9 | To investigate the use of radiographs, fluoroscopy, feeding tubes, and complications associated with blind feeding-tube placement. | Retrospective observational study | 1,822 NET§ were inserted in 729 patients. In 23 patients, the tube was in the pulmonary position and nine had pneumothorax. There was a significant incidence of respiratory complications. Out of every 100 patients, three presented inadvertent tube positioning. |
| 10 | To determine the extent to which aspiration pneumonia are associated with feeding site (controlling for the effects of severity of illness, degree of head-of-bed elevation, level of sedation, and use of gastric suction). | Retrospective observational study | NGT‡/NET§ were inserted and the positioning was confirmed by radiography. The prevalence of pneumonia was significantly lower when the tube was located in the intestine, especially in the jejunum. This relationship remained when other variables were analyzed, including: disease severity and sedation level. |
| 11 | To determine the relationship between enteral nutrition feeding devices in patients admitted to the Internal Medicine Departments and the development of pulmonary complications (bronchial aspiration and aspiration pneumonia). | Retrospective observational study | 2,767,259 hospital discharges were observed; of these, 0.92% were from patients receiving enteral nutrition via an enteral tube. These patients were found to be 15 times more likely to have bronchoaspiration and the risk of mortality was twice as high compared to patients who did not receive an enteral nutrition. |
| 12 | To describe two cases of accidental invasion of the trachea by esophageal tubes. | Case report | Patient underwent abdominal surgery due to dehiscence. Blind NGT‡ is inserted for gastric decompression. Upon arriving at the ICU†, the patient was restless and with increased respiratory rate. Arterial blood gases revealed hypoxemia. Mechanical ventilation had to be adjusted, but chest pectoral expansions were not observed and a radiograph showed that the tube was in the trachea. |
| 13 | To report a case in which passage of a narrow bore nasogastric tube into and through the right main bronchus and accidental soiling of the lung parenchyma with Clinifeed. | Case report | A 56-year-old man with head and neck cancer underwent surgery to remove the tumor. After surgery, NGT‡ was inserted and positioning was confirmed by radiography. About 400 mL of enteral nutrition was started. After the infusion, the patient presented dyspnea, cyanosis and increased heart rate. A new radiograph was performed and the tube was found to be located in the right main bronchus. The tube was removed and the patient required oxygen therapy. |
| 14 | To report three cases of pneumothorax attributable to misplacement of a commercially available mercury-weighted polyurethane feeding tube stiffened by a steel wire stylet. | Case report | A 73-year-old patient, after bypass surgery, had NET§ inserted for enteral nutrition. Positioning was confirmed by radiography, which revealed the presence of the distal tip in the right main bronchus. The tube was removed, however the patient had dyspnea and auscultation of the right lung revealed diminished sounds. A new radiograph was performed and pneumothorax was confirmed. The patient required thoracotomy to treat the adverse event and presented hemorrhage, coma, need for mechanical ventilation and, after seven weeks, he died. |
| 15 | To describe a case of massive intrapulmonary hemorrhage following the insertion of an NGT‡ into the tracheobronchial tree in an awake, alert, and cooperative patient. | Case report | An 82-year-old man suffered a car accident and was hospitalized after clavicle resection surgery. He was intubated with unstable vital signs and pulmonary edema. NGT‡ was required for gastric decompression. Initially, the tube was inserted uneventfully, but after a few minutes, blood was observed through the tube and vital signs decreased. Large amounts of blood returned through the tube. Radiography was performed and it was verified that the tube had crossed the left pleura. By laryngoscopy, the NGT‡ was removed and a left chest tube was required. About 1,500 ml of blood was drained. The patient continued with mechanical ventilation and required gastrostomy. Ninety days later, the patient was discharged home. |
| 16 | To report three cases of a potentially life-threatening complication associated with NGT‡/NET§. | Case report | In two cases, the patients were tracheostomized and required a feeding tube, but the tubes were accidentally removed. During insertion of the new tube, patients had respiratory distress and hypoxemia. The tubes were located in the pleura and pneumothorax was diagnosed. One patient died. The third case involved a patient already using a feeding tube, but it was removed accidentally, requiring a new insertion. The patient had a productive cough and the tube was removed. X-ray showed infiltration in the right lung median lobe and another tube was inserted. |
| 17 | To report a case of accidental activated charcoal instillation into the lung of a 30-year-old man being managed for a cyclic antidepressant overdose. | Case report | NGT‡ was inserted for activated carbon gastric lavage. Then, arterial puncture was performed and blood gases were within the normal range. The tube needed to be replaced without incident. 15 mL of activated charcoal were administered. The patient experienced a sudden change in oxygen saturation and vital signs though. Radiography revealed that the tube was in the right main bronchus and the patient was transferred to the ICU† with the vital signs altered. He needed to be intubated and progressed to pneumonia. |
| 18 | To report an instance of the intrapleural administration of charcoal due to penetration of the pleura by a transbronchial nasogastric tube. | Case report | A 37-year-old woman was hospitalized for poisoning. During transport to hospital, NGT‡ was inserted for administration of 180 mL of activated charcoal for gastric lavage. The patient arrived at the hospital awake but lethargic. An initial x-ray revealed pneumothorax and insertion of the right bronchial tube. The tube was removed and a thoracotomy was performed, from which approximately 500 ml of liquid containing the coal was drained. |
| 19 | To report a case of pneumothorax caused by the improper placement of an NGT‡ in a tracheostomized patient after bilateral lung transplantation. | Case report | A 50-year-old man was admitted for lung transplant surgery. Due to postoperative complications, mechanical ventilation and tracheostomy were required. A NET§ was also inserted. There were three attempts and positioning was confirmed by auscultatory method. There was aspiration of yellowish residue. No radiography was performed because a chest tomography was scheduled. According to the exam, the tube was positioned in the lung and rupture of the right lower lobe pleura was identified. The tube was removed and a thoracotomy was performed. |
| 20 | To describe potentially disastrous outcomes associated with failure to determine when nasally inserted feeding tubes are improperly positioned. | Case report | Two cases were presented. In the first, uneventful NGT‡ was inserted in a 70-year-old patient with stroke and dysphagia. Placement was confirmed by two nurses using the auscultatory method; enteral nutrition was administered. After a few hours, the nurse observed that the patient was dyspneic and cyanotic and was transferred to the ICU†. The tube was found in the lung and the patient died of respiratory complications. In the second case, after 13 days of hospitalization, the patient required a new tube due to accidental removal. The confirmation method was performed by placing the distal tip of the tube in water. No blisters were observed and the enteral nutrition was started. After 3 hours, the patient had respiratory distress; radiography revealed that the tube was in the left main bronchus of the lung. Thoracic drainage was started to remove the fluid. |
| 21 | To report an instance of inadvertent placement of a standard NGT‡ into the left pleural space in a patient with right parietotemporal intracerebral hemorrhage and severe hemineglect on the left side. | Case report | A 69-year-old patient admitted for stroke was drowsy but able to communicate. NGT‡ was inserted for medication and feeding. There were no complications during insertion, and tube positioning was confirmed by abdominal auscultation. 100 mL of enteral nutrition were administered. After a few minutes, the patient had severe dyspnea. Radiography confirmed the positioning of the tube in the left bronchus, pleural effusion and pneumothorax. The tube was removed and patient intubation was required, followed by bronchoscopy and thoracotomy. In addition, the patient had pneumonia. |
| 22 | To report a case where the patient developed both tension pneumothorax and pneumomediastinum when an NGT‡ was inserted. | Case report | A 77-year-old woman was admitted to the ICU† due to diabetic acidosis and subsequent left lower limb amputation. She required mechanical ventilation and, after three days, she was extubated. Six hours later, an attempt was made to insert an NGT‡, but there was difficulty during the procedure and the patient required oxygen supplementation. A new attempt was made, but without success. It was decided to insert the tube with the aid of lubricated biopsy forceps to act as a guide. The positioning of the tube was confirmed by aspiration of residue, but without success. Then the auscultation test was performed, and the result was negative. After a few minutes, the patient presented a reduction in oxygen saturation to 60%, increased blood pressure and tachycardia. The tube was removed and ventilatory support was provided. Radiography revealed right pneumothorax and the patient needed to be intubated again. A chest drain was also required. |
| 23 | To report a case of hydropneumothorax caused by inadvertent placement of a Dobhoff tube. | Case report | A 78-year-old woman was hospitalized due to maxillary carcinoma. She needed a NET§ for enteral nutrition. After tube insertion, the patient presented changes in vital signs (increased heart rate, increased respiratory rate and increased blood pressure). Arterial blood gas confirmed hypoxemia in ambient air and radiography revealed hydropneumothorax. The tube was inserted into the right lung. Enteral nutrition was started without confirming the tube positioning. Thoracoscopy was required to resolve the hydropneumothorax. |
| 24 | To report six cases of intrapleural NGT‡ insertion. | Case report | Six cases of elderly in the ICU† with central nervous system dysfunction were reported. Of these, four were intubated and all had an NGT‡ inserted. The positioning of the tube was confirmed by radiography. In five patients, the tube was inserted into the right main bronchus and in one patient, the tube was inserted into the left bronchus. In five patients, the tube was immediately repositioned and, in one case, the patient received the enteral nutrition through a misplaced tube. Four elderly had pneumothorax. |
| 25 | To analyze the insertion of an NGT‡, though a common clinical procedure, and explore means to improve its safety. | Case report | An 80-year-old patient with previous bypass surgery required mechanical ventilation and remained in the ICU† for a period of time. Patient required an NGT‡ for enteral nutrition and a radiograph was performed to confirm its positioning. The NGT‡ was located in the right pleural space. The tube was removed immediately and after two hours, a new radiograph confirmed pneumothorax. |
| 26 | To report three cases of nasopulmonary misplacement of the feeding tube in an ICU†. | Case report | One week after surgery, an 85-years-old man required an NGT‡ for enteral nutrition. Tube insertion occurred without complications and the tube positioning was confirmed by auscultation method and through the observation of yellowish residue. No misplacement was suspected. Enteral nutrition was started and after the infusion of 1,000 mL, the patient had decreased oxygen saturation, dyspnea and chest pain. Radiography revealed that the tube was in the right main bronchus, but there was no pneumothorax. The liquid was drained and the tube was removed by laryngoscopy. The patient had respiratory distress and a radiograph confirmed the pneumothorax; a chest tube was required. In the second case, a 70-year-old man with hypertension and peripheral vascular disease was admitted for lower limb amputation. He required an NGT‡ for enteral nutrition and insertion occurred uneventfully. Radiography confirmed the placement of the tube in the bronchus, with the extremity located in the pleura. Mild pneumothorax was diagnosed and the tube was removed by laryngoscopy. In the third case, a 65-year-old patient was admitted for pneumonia and was on mechanical ventilation. NGT‡ was inserted uneventfully. Positioning was confirmed by auscultation, which was positive. However, there was aspiration of one and a half liters of enteral nutrition though and fluid was found in the pleura. Radiography confirmed the positioning of the tube in the lung. The tube was removed, but the patient had sepsis. |
| 27 | To describe the bronchoscopic control of a significant and prolonged air-leakage, because of malposition of narrow-bore feeding tube, by placing a newly designed airway prosthesis with one-way valve into the corresponding segmental bronchus responsible for air-leakage source. | Case report | A 38-year-old woman diagnosed with bilateral pneumonia and respiratory failure was mechanically ventilated. An NGT‡ was inserted with the aid of an electromagnetic device. After a few hours, low saturation, tachycardia and hypotension occurred. Radiography revealed pneumothorax and a chest tube was inserted. The tomography showed that the tube was inserted into the tracheobronchial tree and that there was air leakage due to mechanical ventilation. The problem was solved by means of a valve, which was removed with subsequent extubation of the patient. |
| 28 | To report a serious complication of blind NGT‡ insertion in a 65-years-old female patient, which was overlooked and caused severe respiratory failure. | Case report | An NGT‡ was inserted and its positioning was confirmed by abdominal auscultation and radiography. On the following day, the patient presented cough, tachypnea and fever, with pleural effusion and collapse of the right lung lobe. Laryngoscopy confirmed the endotracheal positioning of the tube. This was removed without resistance. A radiograph revealed right pneumothorax and a thoracotomy with 900 mL drainage of the enteral nutrition was required. |
| 29 | To report 3 cases of severe pleuropulmonary complications after routine bedside placement of a narrow-bore enteral feeding tube. | Case report | Cases of severe pulmonary complications were reported after NET§ insertion. In two cases, the radiograph revealed a tube positioned in the lung, causing pneumothorax that needed to be drained. The third case dealt with a patient on mechanical ventilation whose tube was inserted into the lung with consequent pneumothorax. The patient died due to cerebral ischemia. |
| 30 | To report a case of an NGT‡ inadvertently positioned in the respiratory tract. | Case report | A 76-year-old man was admitted with a diagnosis of stroke. He needed a feeding tube due to risk of aspiration. The procedure was performed uneventfully and the patient had no complaints. The physician confirmed the positioning by the auscultation method and the enteral nutrition was released. After a few hours, the patient was transferred to the ICU† due to acute respiratory failure. Radiographic examination revealed the placement of the tube in the lower lobe of the right lung. |
| 31 | To report a case of a misplaced NGT‡ into the pulmonary pleura. | Case report | A 50-year-old man was admitted to the emergency department. On the fourth day of hospitalization, an NGT‡ was inserted and confirmed by radiography. 750 mL of enteral nutrition were administered. The following day, the patient had shortness of breath and pleural effusion and pneumothorax were confirmed. The patient underwent thoracotomy and antibiotic therapy and he was discharged after 33 days. |
| 32 | To report a case of inadvertent NGT‡insertion into the right lower lobe bronchus. | Case report | A 79-year-old man with Chronic Obstructive Pulmonary Disease was admitted to the ICU† and underwent mechanical ventilation. Subsequently, tracheostomy was performed. The patient was using an NET§ for enteral nutrition. A new tube was required and it was blindly inserted by the nurse in the ward. The position of the tube was confirmed by auscultation. Then, enteral nutrition was started. During the night, the nurse verified that the tube was wrapped around the patient's mouth and the tube was inserted again. Immediately after the enteral nutrition was administered, the patient coughed, and after several unsuccessful attempts, the nurse opened the tube and drained it. The following morning, a small amount of liquid was observed through the tracheostomy tube. An x-ray revealed that the tube passed through the tracheostomy balloon and into the right bronchus. The patient was tachypneic and did not respond to external stimuli and he was transferred back to the ICU†. |
| 33 | To report a case of NGT‡ inserted into the pleural cavity passing the trachea and left bronchi. | Case report | An 87-year-old woman hospitalized for pneumonia started an enteral nutrition due to lack of appetite. Two days after insertion of the tube, the patient presented with a decrease in general condition and dyspnea. Radiographs showed that the tube was located in the pleural cavity. Enteral nutrition was found in the left bronchus. The tube was removed and a pleural drain was introduced. The patient had pneumonia and pleuritis and after 12 days she died. |
| 34 | To report an unusual case of malpositioning of a fine bore NGT‡ into both main bronchi in a patient that was awake. | Case report | A 71-year-old woman with hypopharyngeal carcinoma required an NGT‡ after chemotherapy treatment. The tube was obstructed and a new one was required. There was no resistance during insertion, however the patient presented cough. The tube positioning was confirmed by auscultation. Next, a radiograph was performed and revealed that the tube was coiled in both bronchi. The tube was inserted into the left bronchus, bent and migrated to the right bronchus, and was therefore found in both major bronchi. Gastrostomy was required due to esophageal stenosis. |
| 35 | To report a case of accidental tracheal intubation of feeding tube in an intubated patient who developed respiratory distress a few minutes after test feed administration. | Case report | A 32-year-old man suffered a traffic accident with chest trauma, diaphragmatic rupture and fracture of left leg bones. He was operated and referred to the ICU† and an NGT‡ was inserted for feeding. The insertion of the tube occurred uneventfully and its position was confirmed by auscultation. 100 ml of water was administered. After a few minutes, the patient presented respiratory disorder and decreased oxygen saturation, requiring mechanical ventilation. The positioning of the tube was verified again by laryngoscopy, which confirmed the positioning of the distal tip in the trachea. |
| 36 | To report six cases of tracheobronchial malposition of fine bore feeding tube in patients with mechanical ventilation. | Case report | Patient had cough and tachycardia during NGT‡ insertion and bronchoscopy confirmed inadequate positioning of the tube. In four patients, NGT‡/NET§ insertion was performed without complications and the test used to confirm the positioning was auscultation. Subsequently, bronchoscopy and radiography were performed to confirm possible pneumonia. Tests confirmed inadvertent placement of the tube. The sixth patient did not present cough during the insertion of the tube and the epigastric auscultation test was performed to confirm the positioning. A chest computerized tomography confirmed the placement of the tube in the tracheobronchial region. The patient died after 12 days due to the blood infection. |
| 37 | To report three cases of enteral feeding tube malpositioned into the respiratory system. | Case report | In the first case, a mechanically ventilated postoperative patient required an NGT‡ for gastric decompression. The spontaneous drainage bottle was filled with respiratory tidal volume. Radiography indicated that the NGT‡ was positioned in the left main bronchus. New NGT‡ was inserted by laryngoscopy. The second patient had diabetic foot, multiple organ dysfunction and sepsis and was admitted to the ICU† after limb amputation. She was on mechanical ventilation and required a tracheostomy tube. She remained with enteral feeding via NGT‡. After five weeks with the tube, it needed to be replaced as it migrated to the left main bronchus. A new tube was inserted and the positioning was confirmed by radiography. The patient progressed to septic shock and died after 76 days of hospitalization. The third patient had spontaneous intraventricular bleeding and was admitted to the ICU† with respiratory failure. NGT‡ was inserted and positioning was confirmed by radiography, which indicated the location of the distal tip in the right bronchus. The tube was immediately removed and another tube was inserted. The positioning of the new tube was confirmed by radiography. |
| 38 | To report a case describing false-positive NGT‡ placement confirmation tests in a patient with head and neck cancer, who was administered feed into lung parenchyma with significant morbidity. | Case report | A 54-year-old man with head and neck cancer was admitted to the ward for nutritional support. Blind NGT‡ was inserted and positioning was confirmed by pH test. Next, the administration of enteral nutrition began. The next day, the patient complained of nausea and 77% oxygen saturation in room air was observed. Radiography was performed and the positioning of the tube in the lung was confirmed. 540 mL of enteral nutrition were drained from the lung and antibiotic therapy was started. |
| 39 | To report two cases of pneumothorax following small-bore feeding tube insertion into the pleural cavity, resulting in pneumothorax. | Case report | In the first case, NET§ was inserted and the patient showed no signs of respiratory distress during insertion. However, the x-ray confirmed the position of the distal tip in the right main bronchus and consequent pneumothorax. In the second case, an NET§ was inserted in a patient on mechanical ventilation. During insertion, there was no change in oxygen saturation and the cuff remained inflated. However, the x-ray confirmed the placement of the tube in the left lung. Patient presented a decrease in saturation and blood pressure, a hypertensive pneumothorax and a chest tube were inserted. |
| 40 | To report a case of malposition of an NGT‡. | Case report | A 70-year-old man with Chronic Obstructive Pulmonary Disease was admitted for bypass surgery. After surgery, there was a need to insert an NGT‡, which occurred uneventfully. Positioning of the distal tip was confirmed by auscultatory method, but in the ICU†, radiography was performed before beginning the administration of enteral nutrition and medications. X-ray confirmed the placement of the tube in the right main bronchus. |
| 41 | To report the first documented fatality from pressure pneumothorax following NGT withdrawal. | Case report | An 84-year-old woman with dysphagia and risk of aspiration required a feeding tube. After insertion, the patient had difficulty breathing and the x-ray revealed positioning of the tube in the lung. The tube was removed, but the patient died after one hour. Necropsy showed cause of death: pneumothorax after tube withdrawal. |
| 42 | To report a case of severe acute respiratory distress syndrome induced by bronchopleural fistula due to malposition of NGT‡. | Case report | A 67-year-old man received enteral nutrition and, after 17 hours, severe cough and decreased oxygen saturation was observed. The patient was transferred to the ICU† and required mechanical ventilation. The patient had a cough with thick yellow fluid and bronchoscopy. The examination showed the presence of enteral nutrition in the bronchi, and pulmonary lavage was performed. Radiography confirmed pleural effusion, requiring several pulmonary lavages, but not enough improvement in oxygen saturation. After several daily washes, saturation was normalized and thoracentesis was performed to remove pleural fluid. |
| 43 | To report two cases of NGT‡ placement which resulted in significant morbidity from a common procedure. | Case report | An 88-year-old woman, admitted by stroke, required an enteral feeding tube. Two days after the insertion, it needed to be replaced with another one. Positioning was confirmed by the epigastric auscultation method. Soon after, the patient showed agitation and radiography confirmed the positioning of the tube in the right main bronchus and pneumothorax. A chest tube was introduced, but the patient progressed to pneumonia. Subsequently, the medical team chose to feed her via gastrostomy. A 73-year-old patient was admitted to the geriatric ward because of circulatory complications. NGT‡ was inserted for feeding and the position was confirmed by radiography. Enteral nutrition was then released. After five hours, the patient presented respiratory impairment. A new x-ray confirmed that the tube was positioned in the lung and that there was about 300 mL of liquid, as well as abscess and pleural effusion. The fluid was drained and the patient was treated with antibiotics. This adverse event resulted in increased length of hospital stay and death after six months. |
| 44 | To report a case of a right-sided malpositioned NGT‡ which caused a pneumothorax only on its removal. | Case report | An 85-year-old female with advanced dementia was admitted due to severe dehydration caused by poor appetite. Intravenous solutions were infused and NGT‡ was inserted for enteral feeding. Initially, the procedure was uneventful, but a cough was observed. A radiograph was taken and it showed that the tube was positioned in the right main bronchus. The NGT‡ was removed. Then, the patient evolved to thoracic discomfort and the second radiograph found pneumothorax. The patient required supplemental oxygen for two days. |
*
VAP = Ventilator-associated pneumonia;
†
ICU = Intensive Care Unit;
‡
NGT = Nasogastric tube;
§
NET = Nasoenteric tube