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Tension Pneumothorax and Subcutaneous Emphysema Complicating Insertion of Nasogastric Tube.

Al Saif N, Hammodi A, Al-Azem MA, Al-Hubail R - Case Rep Crit Care (2015)

Bottom Line: In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed.Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure.We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement.

View Article: PubMed Central - PubMed

Affiliation: Critical Care Department, King Fahad Specialist Hospital, P.O. Box 15215, Dammam 31444, Saudi Arabia.

ABSTRACT
Nasogastric tube has a key role in the management of substantial number of hospitalized patients particularly the critically ill. In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed. Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure. We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement.

No MeSH data available.


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Mentions: After NG tube insertion, chest X-ray showed misplaced NG tube at the right main bronchus down to the right pleural space and development of new 7.8 mm right sided pneumothorax (Figure 1, chest X-ray). The NG tube had been immediately removed and PEEP was decreased to 5 cmH2O. Over few minutes, the patient became progressively hypotensive and hypoxic, requiring higher doses of norepinephrine infusion and FiO2 of 60% to maintain 95% saturation. Right sided chest tube was inserted and the repeated X-ray revealed new subcutaneous emphysema (Figure 2). Using direct laryngoscopy technique, nasogastric tube was inserted under vision.


Tension Pneumothorax and Subcutaneous Emphysema Complicating Insertion of Nasogastric Tube.

Al Saif N, Hammodi A, Al-Azem MA, Al-Hubail R - Case Rep Crit Care (2015)

© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581497&req=5

Mentions: After NG tube insertion, chest X-ray showed misplaced NG tube at the right main bronchus down to the right pleural space and development of new 7.8 mm right sided pneumothorax (Figure 1, chest X-ray). The NG tube had been immediately removed and PEEP was decreased to 5 cmH2O. Over few minutes, the patient became progressively hypotensive and hypoxic, requiring higher doses of norepinephrine infusion and FiO2 of 60% to maintain 95% saturation. Right sided chest tube was inserted and the repeated X-ray revealed new subcutaneous emphysema (Figure 2). Using direct laryngoscopy technique, nasogastric tube was inserted under vision.

Bottom Line: In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed.Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure.We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement.

View Article: PubMed Central - PubMed

Affiliation: Critical Care Department, King Fahad Specialist Hospital, P.O. Box 15215, Dammam 31444, Saudi Arabia.

ABSTRACT
Nasogastric tube has a key role in the management of substantial number of hospitalized patients particularly the critically ill. In spite of the apparent simple insertion technique, nasogastric tube placement has its serious perhaps fatal complications which need to be carefully assessed. Pulmonary misplacement and associated complications are commonplace during nasogastric tube procedure. We present a case of tension pneumothorax and massive surgical emphysema in critically ill ventilated patient due to inadvertent nasogastric tube insertion and also discussed the risk factors, complication list, and arrays of techniques for safer tube placement.

No MeSH data available.


Related in: MedlinePlus