Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 365-367, July 2008

Inadvertent Tracheobronchial Placement of Feeding Tube in a Mechanically Ventilated Patient

  • Po-Chien Wang

      Affiliations

    • Department of Internal Medicine, Ton-Yen General Hospital, Hsinchu, Taiwan, R.O.C.
    • ,
  • Guan-Ying Tseng

      Affiliations

    • Department of Internal Medicine, Ton-Yen General Hospital, Hsinchu, Taiwan, R.O.C.
    • ,
  • Hsiao-Bai Yang

      Affiliations

    • Department of Pathology, Ton-Yen General Hospital, Hsinchu, Taiwan, R.O.C.
    • ,
  • Kuo-Chih Chou

      Affiliations

    • Department of Internal Medicine, Ton-Yen General Hospital, Hsinchu, Taiwan, R.O.C.
    • ,
  • Chung-Hua Chen

      Affiliations

    • Department of Internal Medicine, Ton-Yen General Hospital, Hsinchu, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Chung-Hua Chen, Department of Internal Medicine, Ton-Yen General Hospital, Jhubei City, Hsinchu County 302, Taiwan, R.O.C

Received 4 October 2007; accepted 3 March 2008.

Article Outline

Nasogastric (NG) tube misplacement into the airways is a rare complication. The presence of a cuffed endotracheal or tracheostomic tube often gives primary care providers a false sense of security. This report presents a case of inadvertent NG tube insertion into the right lower lobe bronchus of a 79-year-old patient with advanced chronic obstructive pulmonary disease, resulting in pneumonia and septic shock. In this report, the literature is reviewed, the influence of tube size on complications is compared, and the reliability of different methods to verify correct tube position is discussed. We conclude that a cuffed tracheostomic tube does not prevent advancement of a large-bore feeding tube into the tracheobronchial system. If any doubt exists regarding proper tube position, a chest radiograph should be obtained prior to initiation of feeding.

Key Words:  complication , feeding tube , misplacement , nasogastric tube

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PII: S1726-4901(08)70141-2

doi:10.1016/S1726-4901(08)70141-2

Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 365-367, July 2008

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