Successful treatment with one-way endobronchial valve of large air-leakage complicating narrow-bore enteral feeding tube malposition.
Tracheopulmonary intubation is the most common misplacement site for narrow-bore feeding tube and it might be associated with severe pleuro-pulmonary complications. A 38-year-old female with a severe bilateral pneumonia and acute respiratory insufficiency was admitted in the ICU, intubated, and mechanically ventilated. Few hours after the insertion of a narrow-bore feeding tube the patient's oxygen saturation dropped with hypotension and tachycardia. A large left-side hydropneumothorax developed requiring a chest tube. Air-leakage was important and bronchoscopic implant of one-way endobronchial valve was accomplished. Immediate and substantial decrease of air-leakage was observed, and it completely stopped after 5 days; as soon as the patient was extubated. Endobrochial one-way valve, specifically designed for bronchoscopic lung volume reduction, resulted in being safe and effective to control a significant and prolonged air-leakage due to a malposition of a narrow-bore feeding tube.
De Giacomo
Tiziano
T
University of Rome La Sapienza, Department of Surgery and Transplantation Paride Stefanini, Rome, Italy. tiziano.degiacomo@tin.it
Venuta
Federico
F
Diso
Daniele
D
Coloni
Giorgio Furio
GF
D000328:Adult; D000388:Air; D001999:Bronchoscopy; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D006872:Hydropneumothorax / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D011859:Radiography; D012137:Respiratory System / Q000000981:diagnostic imaging*