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December 1991

Pneumothorax Following Feeding Tube Placement

Author Affiliations

Bakersfield, Calif

Arch Intern Med. 1991;151(12):2473-2476. doi:10.1001/archinte.1991.00400120105023

To the Editor. —  The article by Wendell et al1 regarding pneumothorax complicating small-bore feeding tube placement is enlightening and useful. We, too, have had difficulty with this situation in lethargic or comatose patients who need nasogastric or nasoenteral feeding, and we have recently adopted a technique that was described by Harris and Huseby.2 A 26-F red rubber catheter is inserted transnasally into the stomach and an 8-F feeding tube subsequently is inserted through the catheter. The feeding tube is advanced the appropriate distance, and the larger external catheter is then cut longitudinally leaving only the feeding tube in place. Following this technique, the likelihood of pulmonary insertion of the feeding tube has been significantly reduced.Another technique that we have recently reviewed——but not gathered significant data on, but which appears promising—is the use of a pH-sensitive gastric or enteral probe that allows localization within the gastrointestinal tract

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