Fuentes-Mallozzi DA, Mote-Amador L

Language: Spanish
References: 11
Page: 180-182
PDF size: 157.83 Kb.

ABSTRACT

The installation of transpyloric tube is a common procedure in critically ill children. This kind of tubes offers a secure way to feed. The technique of the installation is easy, but the complications can be dangerous, like esophagitis, esophageal perforation and tracheobronchial installation. 13 years old male, with astrocytoma in posterior fossa, after its resection by surgery he had a bad neurological evolution with prolongation of mechanical ventilation and sedation. We performed the installation of a transpyloric tube to start the enteral feeding, but it was introduced accidentally in his left bronchi. An X-ray picture revealed the misplacement of the feeding tube. The transpyloric tube can be dangerous and could increase the morbidity if is misplaced. It was made a review of literature about the technique and complications in the installation of nasoenteral tubes, we offer some recommendations.

REFERENCES

1. Barrionuevo L, Eulmesekian P, Pérez A et al. Colocación de sondas transpilóricas en la Unidad de Cuidados Intensivos Pediátricos: la técnica de insuflación gástrica de aire. Arch Argent Pediatr. 2009; 107: 542-566.

2. Zausig YA, Graf BM, Gust R. Ocurrence of a pneumothorax secondary to malpositioned nasogastric tube: a case report. Minerva Aenestiol. 2008; 74: 735-738.

3. Creel AM, Winkler MK. Oral and nasal enteral tube placement errors and complications in a pediatric intensive care unit. Pediatr Crit Care Med. 2007; 8: 161-164.

4. Wang PC, Tseng GY, Yang HB, Chou KC, Chen CH. Inadvertent tracheobronchial placement of feeding tube in a mechanically ventilated patient. J Chin Med Assoc. 2008; 71 (7): 365-367.

5. Umuroğlu T, Varlık DI, Yayc A. Misplacement of a nasogastric tube into the postpneumonectomy space. Marmara Medical Journal. 2004; 17 (2): 78-80.

6. Pillai JB, Vegas A, Brister S. Thoracic complications of nasogastric tube: review of safe practice. Interact Cardiovasc Thorac Surg. 2005; 4: 429-433.

7. Escudero A, Sariñena MT, Rodríguez NM, Llubiá C. Sonda nasogástrica lastrada con el extremo distal en el árbol bronquial derecho. Rev Esp Anestesiol Reanim. 2005; 52: 515-516.

8. Soto MJC, Luviano GJA, García RJC et al. Instalación bronquial de sondas nasoenterales. Presentación de dos casos y revisión de la literatura. Rev Asoc Mex Med Crit y Ter Int. 2010; 24: 94-98.

9. Rassias JA, Ball AP, Corwin LH. A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes. Crit Care. 1998; 2: 25-28.

10. Giantsou E, Gunning JK. Blindly inserted nasogastric feeding tubes and thoracic complications in intensive care. Health 2010; 2: 1135-1141.

11. Villasís KMA, Hernández GV, Cárdenas NR, et al. Complicaciones relacionadas a la alimentación enteral con sonda en pacientes pediátricos. Bol Med Hosp Infant Mex. 1999; 56: 18-26.