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Report of Four Cases, Review of the Literature, and Recommendations for Prevention

Ronenn Roubenoff, MD; William J. Ravich, MD

Arch Intern Med. 1989;149(1):184-188.

Abstract
• Intrapulmonary placement of small-bore nasogastric feeding tubes caused pneumothoraces in four patients. Review of the literature discloses another 106 cases of the same complication. Risk factors for intrapulmonary complications include endotracheal intubation or tracheostomy (60% of reported cases [95% confidence interval, 44% to 80%]), and altered mental status (36% of reported cases [95% confidence Interval, 24% to 53%]). We propose a simple, two-step method of feeding tube insertion designed to prevent such complications in high-risk patients.

(Arch Intern Med 1989;149:184-188)

Author Affiliations
From the Department of Medicine, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore.

Footnotes
Accepted for publication July 21, 1988.

Presented in part at the 12th Annual Congress of the American Society for Parenteral and Enteral Nutrition, Las Vegas, Jan 19, 1988.

Reprint requests to Suite 7500, 1830 E Monument St, Baltimore, MD 21205 (Dr Roubenoff).

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