Use of polyvinyl feeding tubes and iatrogenic pharyngo-oesophageal perforation in very-low-birthweight infants.
BACKGROUND
Placement of a feeding tube may be associated with various complications, including iatrogenic pharyngo-oesophageal perforation.


OBJECTIVE
To determine the incidence of pharyngo-oesophageal perforation secondary to the use of polyvinyl feeding tubes in newborns weighing less than 1500 g, we conducted a retrospective study over a 3(1/2)-y period.


METHODS
All the hospital files of the 371 very-low-birthweight newborns admitted were retrospectively reviewed.


RESULTS
Three iatrogenic pharyngo-oesophageal perforations were observed, giving an incidence of 1:124 preterm infants. This incidence reaches values of 1:25 newborns weighing less than 750 g. Data from our cases included clinical presentation and outcome, radiological evaluation, and type of feeding tube. One infant died of sepsis, and the clinical course was compatible with mediastinitis. The other two infants were treated successfully with conservative non-surgical management.


CONCLUSIONS
Pharyngo-oesophageal perforation in our experience exclusively involved preterm infants weighing less than 750 g after traumatic placement of a polyvinyl feeding tube. The use of a silastic feeding tube with a really soft end instead of polyvinyl catheters could probably avoid iatrogenic oesophageal perforation.
Filippi
Luca
L
Neonatal Intensive Care Unit, Department of Critical Care Medicine, University Careggi Hospital, Florence, Italy. filippi.luca@virgilio.it
Pezzati
Marco
M
Poggi
Chiara
C
D004750:Enteral Nutrition; D004939:Esophageal Perforation / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D010614:Pharynx / Q000293:injuries*; D011145:Polyvinyls
D011145:Polyvinyls