Chest
Volume 88, Issue 2, August 1985, Pages 230-233
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Clinical Investigations
Pleuropulmonary Complications of Enteral Tube Feedings: Two Reports, Review of the Literature, and Recommendations

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Enteral tube feeding is an attractive alternative to intravenous alimentation for nutritional support. As previously used nasogastric tubes have been replaced with narrow-bore nasogastric tubes, the spectrum of complications seen with these devices has changed. We report a previously undescribed event associated with narrow-bore nasogastric tube feeding, review the literature, noting predisposing factors and complications, and suggest guidelines to avoid pitfalls of insertion and the ensuing adverse effects.

Section snippets

Case 1

A 68-year-old woman with chronic obstructive pulmonary disease (COPD) was admitted to the Medical University Hospital for increasing shortness of breath. Pulmonary angiograms documented pulmonary thromboembolism, and therapy with heparin was initiated. The patient's medical history was complicated by chronic renal insufficiency, nephrotic syndrome of undefined etiology, a right mastectomy for breast cancer, and probable primary hyperparathyroidism. Worsening respiratory failure required

Discussion

When a foreign object is inserted into the body, it can cause injury from the site of entry to the site of distal placement. Since the introduction of nasogastric tubes, refinements have been made, and the spectrum of injuries has changed. Earlier large-bore stiff tubes (16 to 20 French) were inserted easily,10 but there were problems related to the patients comfort and to ischemia and necrosis of superficial tissues due to compression of the tube against mucosal surfaces. Ulceration and

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Manuscript received December 20; revision accepted January 30.

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