Case Series: Nasogastric (NG) Feeding Tube Misplacement in Critically Ill Tracheostomized Patients

Yoav Comay,Leonid Koyfman,Elchanan Quint,Asaf Acker,Anton Osyntsov,Evgeni Brotfain,Yoav Bichovsky

doi:10.4236/crcm.2020.912055

Abstract

In this case series we present 3 cases of nasogastric tube misplacement in tracheostomy patients. Although considered safe and it being a common procedure nasogastric tube misplacement can lead to serious and life-threatening complications. We present three cases of nasogastric tube misplacement in tracheostomized patients. One of the cases presented suffered from pneumothorax. Different time intervals between procedures in these different cases resulted in similar results. We would like to emphasize the importance of due conformation of correct placement of the nasogastric tube in the tracheostomy patient as well as to suggest that over inflation of the balloon securing the tracheostomy apparatus in place during nasogastric tube placement, might prevent misplacement. Nasogastric tube placement in tracheostomized patients has potential for serious complications. As such maintaining safe practice procedure is essential. Considering over inflation of the tracheostomy apparatus balloon might be beneficial as well, by preventing entry of NGT into the trachea.

Highlights

IntroductionThe procedure is performed for medication administration, enteral nutrition and stomach lavage and decompression
Pneumothorax is a leading cause of morbidity [1] [4] [5] [6] [7] [8]. In this case series presentation, we report 3 cases of Nasogastric tube (NGT) misplacement in patients with tracheostomy in our intensive care units (ICU) department, some of which resulted in serious complications
Based on the literature and the case series we reported in this article, we would like to emphasize the risk of NGT misplacement in mechanically ventilated patients and patients who underwent tracheostomy

Summary

Introduction

The procedure is performed for medication administration, enteral nutrition and stomach lavage and decompression. While considered safe this procedure may cause severe complications during insertion [2] [3]. Complications can be classified as intrathoracic misplacement and outer thoracic misplacement [4]. Pneumothorax is a leading cause of morbidity [1] [4] [5] [6] [7] [8] In this case series presentation, we report 3 cases of NGT misplacement in patients with tracheostomy in our ICU department, some of which resulted in serious complications

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Discussion

Conclusion