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July 5, 1985

Complications During Insertion of Narrow-Bore Feeding Tubes

Author Affiliations

USN Branch Clinic, Naval Station Mayport, Fla

JAMA. 1985;254(1):54-55. doi:10.1001/jama.1985.03360010060013

To the Editor.—  I have read with interest the article by Hand et al1 entitled "Inadvertent Transbronchial Insertion of Narrow-Bore Feeding Tube Into the Pleural Space." Several comments seem appropriate. Vaughan2 reported a somewhat similar case on a patient after left hemiglossectomy and left radical neck dissection with tracheostomy. A fine-bore feeding tube was passed into and through the right main-stem bronchus and into the lung parenchyma. Before the chest radiograph was reviewed, 400 mL of a proprietary nutritive amino acid preparation (Clinifeed) was infused. The patient became hypotensive, cyanotic, tachycardic, and dyspneic, and the physical examination revealed bronchospasm. Emergency medical therapy was begun and the patient made an uneventful recovery.Several assertions made within the article are not supported by the stated reference. Concerning intracranial passage, Bauzarth3 dealt with an 18-F nasogastric tube passed within a No. 34 Davol-Silastic nasopharyngeal airway. He recommended this to prevent