title: Pneumothorax following nasogastric feeding tube insertion in a tracheostomized patient after bilateral lung transplantation.
abstract: We report the case of a pneumothorax caused by the improper placement of a nasogastric feeding tube in a tracheostomized patient after bilateral lung transplantation. We discuss the contribution of low-pressure cuffed tracheostomy tubes to the inadvertent respiratory tract misplacement of a nasogastric feeding tube, as well as the problems of nasogastric feeding tube insertion in the sedated patient, why the previously installed closed-tube thoracostomy did not prevent the pneumothorax and possible pitfalls in confirming the proper position of the nasogastric feeding tube. In conclusions, we stress that in high risk patients a nasogastric feeding tube should only be inserted under direct vision and that a subsequent routine X-ray is mandatory for confirming proper positioning.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Leopold-Franzens-University of Innsbruck, Austria. kolbitsch@uibk.ac.at
authors.forename: C
authors.initials: C
authors.lastname: Kolbitsch
authors.forename: A
authors.initials: A
authors.lastname: Pomaroli
authors.forename: I
authors.initials: I
authors.lastname: Lorenz
authors.forename: M
authors.initials: M
authors.lastname: Gassner
authors.forename: T J
authors.initials: TJ
authors.lastname: Luger
mesh_terms: D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D016040:Lung Transplantation; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014139:Tracheostomy