Narrow Bore Nasogastric Feeding Tube Complications

Bohnker, Bruce K.; Artman, Lee E.; Hoskins, William J.

doi:10.1177/088453368700200506

Cited by 12 publications

(9 citation statements)

References 57 publications

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“…Review of the literature confirms our experience with auscultation for verification of tube placement in the stomach [6,8,9,12]. Similarly, aspiration of gastric contents for confirmation can also be misleading [8]. We require a chest roentgenogram prior to the initiation of feeding.…”

Section: Discussionmentioning

confidence: 93%

A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes

1998

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Background:In order to determine the type and incidence of pulmonary complications associated with the placement of narrow-bore enteral feeding tubes we conducted a prospective, descriptive study in the multidisciplinary intensive care unit (ICU) of a university hospital. All patients that had narrow-bore enteral feeding tubes inserted over a 2-year period (1993-1995) were included. The study required no clinical interventions.Results:Seven hundred and forty feeding tubes were inserted during the study period. In 14 cases (2%), the feeding tube was inserted into the tracheopulmonary system. Five patients (0.7%) suffered a major complication, including two (0.3%) who died from complications directly related to the feeding tube placement. All patients had altered consciousness and 13 of the 14 had endotracheal tubes in place. Malposition of the feeding tube was not predictable from clinical signs and auscultation, but was detectable by chest roentgenogram.Conclusions:Inadvertent insertion of enteral feeding tubes into the tracheopulmonary system during placement is associated with significant morbidity and mortality. Clinical signs at the time of insertion are not useful in identifying feeding tubes which are malpositioned. In the ICU patient, a chest roentgenogram is required after all feeding tube insertions prior to the initiation of enteral feeding. In the high-risk patient, alternatives to blind feeding tube insertion should be considered.

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Section: Discussionmentioning

confidence: 93%

A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes

1998

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“…Both airway penetration and introduction of various chemicals into the lung and pleural spaces may occur prior to recognition of tube misplacement and can be fatal [1,6,8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Inadvertent insertion of these tubes into the trachea and distal airways is reported to range from 0.3% to 15% [1][2][3]. Critically ill, mechanically ventilated patients are at a higher risk for complications associated with nasoenteric tube insertion including that of insertion into the airways [2,4].…”

Section: Introductionmentioning

confidence: 99%

“…Critically ill, mechanically ventilated patients are at a higher risk for complications associated with nasoenteric tube insertion including that of insertion into the airways [2,4]. Both airways penetration and introduction of various chemicals into the lung and pleural spaces may occur prior to recognition of tube misplacement and can be fatal [1,5,6].…”

Section: Introductionmentioning

confidence: 99%

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Confirmation of Nasogastric Tube Placement by Colorimetric Indicator Detection of Carbon Dioxide: A Preliminary Report

Thomas

Falcone

1998

Journal of the American College of Nutrition

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“…As complicações da terapia nutricional enteral se relacionam basicamente com: mal posicionamento da sonda, contaminação, administração inadequada da dieta ou intolerância a algum componente da fór-mula (2,5,20,34) . As sondas de fino calibre não prejudicam a capacidade de contração esfincteriana, diminuindo o risco de refluxo gástrico e um conseqüente risco de pneumonia aspirativa, principalmente em pacientes inconscientes ou com reflexos diminuídos.…”

Section: Complicações E Cuidados Geraisunclassified

Sonda nasogástrica/nasoentérica

Unamuno

Marchini

2002

Medicina (Ribeirão Preto)

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UNAMUNO MRDL & MARCHINI JS. Sonda nasogástrica/nasoentérica: cuidados na instalação, na administração da dieta e prevenção de complicações. Medicina, Ribeirão Preto, 35: 95-101, jan./mar.2002. RESUMO: Cada dia mais, a terapia nutricional é reconhecida como importante fator na recuperação de doentes. As sondas modernas possibilitam a oferta de nutrientes e a melhora do estado nutricional, por meio de métodos pouco invasivos, desde que o aparelho digestivo tenha conservado, pelo menos, parte de sua capacidade de absorção. O procedimento requer cuidados especializados, posto que não é isento de complicações. A equipe que assiste o paciente que recebe terapia nutricional através de sondas deve ter conhecimento da instalação das mesmas bem como da administração das dietas e treinamento para prevenir, reconhecer e tratar as complicações. Apresentamos, neste artigo, as técnicas de introdução das sondas, infusão das dietas e principais complicações, que podem advir dessa terapia.UNITERMOS: Nutrição Enteral. 95 INTRODUÇÃODesde as eras mais antigas, buscavam-se outras vias para alimentar pacientes impedidos de comer pela boca. Os egípcios alimentavam seus pacientes através de sondas retais e, com o passar dos anos, houve empenho em se fabricarem tubos de alimentação, que possibilitassem maior conforto aos pacientes. Muitos materiais foram utilizados para a confecção de sondas nasoentéricas, entre eles a borracha, o polietileno e, mais recentemente, o poliuretano e o silicone (1) . Ao mesmo tempo em que se buscava melhorar as sondas, também houve progresso nas formulações dieté-ticas para a terapia nutricional enteral (2,3) .Na década de setenta, Liffmann & Randall (1) e Dobbie & Hoffmeister (4) construíram sondas de jejunostomia e sondas nasais de fino calibre, com uma ogiva distal que possibilitava o posicionamento delas além do esfíncter piloro e permitia a administração de dietas de maneira mais confortável e segura principalmente nos pacientes idosos, acamados e com reflexos diminuídos. Esse tipo de sonda passou a ser conhecido como sonda de DOBBHOFF, que, hoje, são fabricadas em poliuretano e silicone, materiais que não sofrem alteração física na presença de pH ácido, conservam flexibilidade, maleabilidade e durabilidade, não irritam a mucosa digestiva, e, por serem de pequeno calibre, permitem o fechamento dos esfíncteres cárdia Medicina, Ribeirão Preto,

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Narrow Bore Nasogastric Feeding Tube Complications

Cited by 12 publications

References 57 publications

A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes

A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes

Confirmation of Nasogastric Tube Placement by Colorimetric Indicator Detection of Carbon Dioxide: A Preliminary Report

Sonda nasogástrica/nasoentérica

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