Complications related to feeding tube placement.
OBJECTIVE
Blind placement of a feeding tube can result in serious complications. Given the widespread use of tube feedings, even a small percentage of such problems can affect a significant number of people. The purpose of this review is to describe recent reports of feeding tube placement problems and to examine possible solutions.


RESULTS
Multiple case reports of complications of malpositioned feeding tubes continue to surface; most are due to inadvertent placement in the respiratory tract. A tube with feeding ports in the esophagus significantly increases risk for aspiration, as does the displacement of a small bowel tube into the stomach of a patient with significantly slowed gastric motility. Isolated reports of a nasally placed tube entering the brain following head injury continue to occur, as do reports of esophageal and gastric perforation in neonates. A recent study showed that malpositioned tubes are not routinely recorded in risk management databases; it further demonstrated that a comprehensive intervention to reduce complications from small-bore nasogastric feeding tubes was effective.


CONCLUSIONS
Complications related to malpositioned feeding tubes are usually preventable. Poor reporting of feeding tube placement errors hinders the adoption of effective protocols to prevent such errors.
Metheny
Norma A
NA
Saint Louis University School of Nursing, St Louis, Missouri 63104, USA. methenna@slu.edu
Meert
Kathleen L
KL
Clouse
Ray E
RE
D004750:Enteral Nutrition / Q000009:adverse effects*; D004844:Epistaxis / Q000175:diagnosis / Q000209:etiology; D004939:Esophageal Perforation / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology; D053120:Respiratory Aspiration / Q000175:diagnosis / Q000209:etiology; D012852:Sinusitis / Q000175:diagnosis / Q000209:etiology; D013270:Stomach / Q000293:injuries