NAZOGASTRİK SONDANIN ÖLÜMCÜL KOMPLİKASYONU: PNÖMOTORAKS

Nazogastrik sonda (NG), gastrointestinal sisteme en sık yerleştirilen cihazdır. Boğulur gibi olma, öğürme veya öksürme, ses değişikliği, sondada buğulanma görülmesi yanlış lokalizasyonda olduğu konusunda hekimi uyarmalıdır. Sondanın yerinin doğrulanmasında en hızlı ve basit yöntem sonda içinden hava geçirilmesidir. Nazogastrik sonda yerleştirilmesi genelde sıradan bir işlem olarak görülmekteyse de, hayatı tehdit edici ciddi komplikasyonlara sebep olabilir. Yazımızda, nadir görülen hayatı tehdit eden bir komplikasyon olan solunum yoluna nazogastrik sonda uygulanması olgusunun bulgularını, tanı-tedavi yöntemlerini literatür bilgileri eşliğinde gözden geçirdik.

Anahtar Kelimeler:

Nazogastrik sonda, komplikasyonlar, pnömotoraks, solunum yolları

A FATAL COMPLICATION OF THE NASOGASTRIC TUBE: PNEUMOTHORAX

Naso-gastric tube is the instrument, mostfrequently placed into gastrointestinal system. The signs such as feeling of asphyxiate, gagging and coughing, sound change, and observed condensation on tube must alert the physician that the tube might be situated at wrong localization. The quickest and simplest method to correct the localization of tube is passing air through the tube. Even though naso-gastric tube placement is generally considered to be an ordinary operation, it may result in life-threatening complications. In this paper, in company with the information obtained literature, we review the findings of and diagnosistreatment methods for the case of naso-gastric tube placement into respiratory tract, which is a rarely-seen but life-threatening complication.

Keywords:

Nasogastric tube, complications, pneumothorax, respiratory tract,

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1. Metheny NA, Meert KL. Monitoring feeding tube placement. Nutr Clin Pract. 2004; 19(5): 487-95.
2. Pillai JB, Vegas A, Brister S. Thoracic complications of nasogastric tube:review of safe practices. Interact CardioVasc Thorac Surg 2005; 4:429-33.
3. McDanal JT, Wheeler DM, Ebert J. A complication of nasogastric intubation:pulmonary hemorrhage. Anesthesiolgy 1983; 59:356-8.
4. Rassias AJ, Ball PA, Corwin HL. A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes. Critical Care 1998; 2:25-8.
5. Benya B, Langer S, Morbarhan S. Flexible nasogastric feeding tube tip immediately after placement. Journal of Parenteral and Enteral Nutrition 1990; 141:108-9.
6. Hooker EA. Complications of gastrointestinal devices. In: Tintinalli JE, Kelen GD, Stapczynski JS. Emergency Medicine: A Comprehensive Study Guide. New York, McGraw Hill, 2000:599.
7. Bankier AA, Wiesmayr MN, Henk C, et al: Radiographic detection of intrabronchial malpositions of of nasoenteric tubes and subsequent complications in intensive care units. Intens Care Med 1997; 23:406-10.
8. Kawati R, Rubertsson S. Malpositioning of fine bore feeding tube: a serious complication. Acta Anaesthesiol Scand 2005; 49:58-61.