Radiographic detection of intrabronchial malpositions of nasogastric tubes and subsequent complications in intensive care unit patients

A. A. Bankier, M. N. Wiesmayr, C. Henk, K. Turetschek, F. Winkelbauer, R. Mallek, D. Fleischmann, K. Janata, C. J. Herold

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

Objective: The aim of our study was to illustrate the radiographic spectrum of the intrabronchial malposition of nasogastric tubes and subsequent complications, and to discuss the role of radiography in the detection of such malpositions. Design: Retrospective clinical investigation. Setting: Tertiary care university teaching hospital. Patients and methods: We reviewed chest radiographs of l4 intensive care patients with nasogastric tubes malpositioned in the tracheobronchial tree. The site and anatomic location of the malposition were recorded. Complications due to tube malpositioning were monitored on follow-up radiographs and on computed tomographic examinations, which were available in 4 patients. Results: Nine of 14 nasogastric tubes were inserted in the right and 5 in the left tracheobronchial tree. Tube tips were malpositioned in the lower lobe bronchi (50%), the intermediate bronchus (36%), and the main bronchi (14%). There was perforation of the bronchial system with subsequent pneumothorax in 4 patients. In 4 other patients, pneumonia developed at the former site of the malpositioned tube tip. Radiographic detection of nasogastric tube malpositioning was prompt in 9 patients and delayed in 5 patients. Concluions: Whereas clinical signs of nasogastric tube malpositioning in intensive care patients may be absent or misleading, chest radiography can accurately detect nasogastric tube malpositions in the tracheobronchial tree, may prevent complications, and avoid the use of further costly or invasive diagnostic techniques.

Original languageEnglish (US)
Pages (from-to)406-410
Number of pages5
JournalIntensive Care Medicine
Volume23
Issue number4
DOIs
StatePublished - 1997
Externally publishedYes

Keywords

  • Bedside
  • Chest radiography
  • Lung infection
  • Nasogastric tubes
  • Pneumothorax
  • Postprocedural chest radiography

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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