Four patients had soft, narrow-bore feeding tubes passed transbronchially into the pleural space. Guide wires were used to aid passage and may have contributed to this complication. The errant positioning of the tube was first noted roentgenographically in each case. Alternate methods of inserting such tubes in patients with altered airway and swallowing reflexes may be needed. Radiographic confirmation of the tube's position is essential before starting tube feedings.
Hand RW, Kempster M, Levy JH, Rogol PR, Spirn P. Inadvertent Transbronchial Insertion of Narrow-Bore Feeding Tubes Into the Pleural Space. JAMA. 1984;251(18):2396–2397. doi:10.1001/jama.1984.03340420062028
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