Techniques, Procedures, and Devices A Technique for Positioning Nasoenteral Feeding Tubes

ABSTRACT. The use of nasoenteral alimentation in many neurologically depressed patients is a common practice. These patients are also at increased risk of sustaining feeding tube malplacement. The morbidity and mortality involving feeding tube malposition in these debilitated patients is high. In this paper, we present four case reports of morbidity, with one resultant mortality, associated with small-bore nasoenteral tube malposition. We are also suggesting a nasoenteral intu-bation protocol which we feel will decrease the incidence of feeding tube malplacement. (Journal of Parenteral and Enteral Nutrition 11:210-213, 1987) Since the nasoenteral feeding tube was introduced by Dobbie and Hoffmeister,I.2 its use has been widely ac-cepted in the nutritional care of critically ill patients. In early reports, the tube’s placement was considered easy and safe, and complications were minimal. Since that time, however, multiple reports have been published3-12 of pneumothorax related to their use. We are reporting four cases of such tube malplacement. Three of the patients developed life-threatening pneumothorax asso-ciated with malplacement of a polyurethane tube with a mercury-weighted tip and a wire stylet (Entriflex, Bio