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March 1969

Tube Feeding Syndrome in Head and Neck Surgery

Author Affiliations


From the Division of Head and Neck Surgery, University of California, Los Angeles. Dr. Walike is currently at the University of Washington, Department of Otolaryngology, Seattle.

Arch Otolaryngol. 1969;89(3):533-536. doi:10.1001/archotol.1969.00770020535016

INCREASING sophistication in head and neck operative procedures frequently involves routine and often prolonged postoperative nasogastric feeding. The purpose of this paper is to call attention to a little recognized and sometimes dire complication of tube feeding.

Hypernatremia and hypertonicity have been reported in a number of clinical conditions including primary neurologic disorders without renal disease,1 nephrosis following sulfathiazole therapy,2 solute diuresis,3 transient diabetes insipidus following neurosurgical procedures,4 during the recovery phase of diabetic acidosis,5 head injury,4 and diarrhea.3 Welt et al described the role of the central nervous system (CNS) in the metabolism of electrolytes and water.6 Schoolman et al7 reported 100 cases of hypernatremia but did not implicate tube feeding as a factor or cause.

In 1954, Engel and Jaeger8 first described dehydration, hypernatremia, hyperchloremia, and azotemia as a complication of nasogastric tube feeding. This constitutes the tube feeding

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