scholarly journals Failure of drip and suck in postoperative ileus: a faulty non-perforated NG tube

2019 ◽  
Vol 12 (6) ◽  
pp. e230112
Author(s):  
David Bristow ◽  
James Shaw
Keyword(s):  
Acute Abdomen ◽  
Nasogastric Tube ◽  
Medical Equipment ◽  
Postoperative Ileus ◽  
Symptom Relief ◽  
Nausea And Vomiting ◽  
Patient Harm ◽  
Gastric Contents ◽  
Gastric Decompression ◽  
Risk Of Aspiration

A 55-year-old woman developed a postoperative ileus with associated nausea and vomiting following an elective laparotomy. A wide bore nasogastric (NG) tube was inserted for gastric decompression and symptom relief. Aspiration of the tube was unsuccessful and the patient continued to vomit. Imaging to investigate the acute abdomen demonstrated the nasogastric tube to be correctly sited and within pooled gastric contents. Gentle initial attempts were made to unblock the NG but to no avail and therefore it was removed. On inspection it was discovered that the NG tube had no distal perforations to allow drainage, causing failure and increasing the patient’s risk of aspiration. The aim of this report is draw attention to the importance of scrutinising all medical equipment prior to use to prevent avoidable and potentially serious patient harm.

The Efficacy and Safety of Methylnaltrexone for the Treatment of Postoperative Ileus

2021 ◽  
pp. 000313482110488
Author(s):  
Jennifer Beavers ◽  
Lindsay Orton ◽  
Leanne Atchison ◽  
Andrew Medvecz ◽  
Bradley Dennis ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Postoperative Ileus ◽  
Primary Outcome ◽  
Surgical Complication ◽  
Opioid Antagonist ◽  
Control Group ◽  
Efficacy And Safety ◽  
Gastrointestinal Malignancy ◽  
Gastric Decompression ◽  
Bowel Rest

Background Postoperative ileus (POI) is a surgical complication resulting in increased morbidity and length of stay (LOS). Usual care for POI includes bowel rest and gastric decompression. It has been questioned if methylnaltrexone (MNTX), a peripheral opioid antagonist, could be used as treatment for POI. The purpose of this study was to determine if MNTX is effective and safe for POI treatment. Methods This single-center, retrospective cohort study included patients ⩾ 18 years with a POI. Patients with acute colonic pseudo-obstruction, small bowel obstruction, and gastrointestinal malignancy were excluded. The intervention was MNTX administration. The primary outcome was time to ileus resolution. Secondary outcomes included LOS, duration of nasogastric tube, total parenteral nutrition requirement, and incidence of gastrointestinal perforations. Results 110 patients were included in the analysis; 28 received MNTX. Time to ileus resolution was 9.9 days for the MNTX group and 11.4 days for the control group ( P = .38). Duration of gastric decompression was 4.6 days for the MNTX group and 4.2 days for the control group ( P = .71). Length of stay was 19.9 days for the MNTX group and 19.7 days for the control group ( P = .96). The percentage of TPN requirement was 17.9% in the MNTX group and 22.0% in the control group ( P = .65). No gastrointestinal perforations were observed in either group. Conclusion For the treatment of POI, MNTX did not significantly reduce time to resolution of ileus, LOS, duration of gastric decompression, or TPN requirements. However, no gastrointestinal perforations were seen, indicating that MNTX may be safely used in these patients.

To Be or Knot to Be: A Rare Case of Nasogastric Tube Knotting

2020 ◽  
pp. 97-99
Author(s):  
Muzna Iftikhar ◽  
Shahbaz Bakhat Kayani ◽  
Atiq Ur Rehman
Keyword(s):  
Respiratory Distress ◽  
Young Patient ◽  
Nasogastric Tube ◽  
Tracheoesophageal Fistula ◽  
Rare Case ◽  
Rare Complication ◽  
Clinical Care ◽  
Nasogastric Intubation ◽  
Laryngeal Injury ◽  
Gastric Decompression

Nasogastric intubation is a frequent practice in clinical care used for administering enteral feed, gastric decompression, and lavage. The knotting of a nasogastric tube is a rare complication with only a few incidences of narrow bore nasogastric tube knotting and even fewer wide-bore tubes reported [1-4]. Unrecognized knotting of the nasogastric tube with inadvertent removal may cause catastrophic consequences like epistaxis, respiratory distress’ severe laryngeal injury, and tracheoesophageal fistula [5-7]. Tubes have been found to be kinked and less commonly knotted. Cases of knotting have previously been identified during insertion or blockage of the tubes post-insertion. Ours is a case of nasogastric tube knotting identified in a young patient with a working tube that knotted over itself during removal.

scholarly journals A Simple Technique for Diagnosing Oesophageal Intubation

1989 ◽  
Vol 17 (1) ◽  
pp. 39-43 ◽  
Author(s):  
M. Kalpokas ◽  
W. J. Russell
Keyword(s):  
Endotracheal Tube ◽  
Nasogastric Tube ◽  
Simple Technique ◽  
Morbidity And Mortality ◽  
Endotracheal Tubes ◽  
Gastric Contents ◽  
Oesophageal Intubation ◽  
Continuous Suction

Undiagnosed oesophageal intubation during anaesthesia is a major cause of anaesthetic-related morbidity and mortality. A test was devised and evaluated to distinguish between placing an endotracheal tube in the trachea and in the oesophagus. The test involves threading a lubricated nasogastric tube through the endotracheal tube, applying continuous suction to the nasogastric tube and then attempting to withdraw the nasogastric tube. Four aspects distinguish an endotracheal tube in the trachea from one in the oesophagus: 1. the length of nasogastric tube inserted and the feel of the final obstruction to further insertion, 2. the ability to maintain unobstructed suction through the nasogastric tube, 3. the ease of withdrawal of the nasogastric tube during continuous suction, 4. the nature of any aspirate (i.e. mucus or gastric contents). An evaluation was performed on twenty patients in whom both the trachea and oesophagus were intubated simultaneously. In all twenty cases, each of the two endotracheal tubes was correctly identified as being either tracheal or oesophageal. The ability to maintain suction and the ease of withdrawal most clearly distinguished between the two positions.

Aspiration Pneumonitis

2017 ◽  
Author(s):  
Agnieszka Trzcinka
Keyword(s):  
Risk Factors ◽  
Delayed Gastric Emptying ◽  
Perioperative Period ◽  
Pulmonary Aspiration ◽  
Aspiration Pneumonitis ◽  
Anesthesia Induction ◽  
Supportive Treatment ◽  
Gastric Contents ◽  
Upper Abdominal ◽  
Risk Of Aspiration

Aspiration pneumonitis during the perioperative period is a serious complication and involves passage of sterile gastric contents into the airway resulting in alveolar damage. The mechanism of aspiration pneumonitis is characterized by a significant inflammatory reaction. The risk of aspiration is highest during anesthesia induction, but it is also present during emergence and extubation. The risk factors include delayed gastric emptying (gastritis, pain, pregnancy, obesity, elevated intracranial pressure), emergency surgery, upper abdominal surgery, and difficulty securing the airway. Anesthesiologists should focus on prevention of pulmonary aspiration with consideration of the patient’s NPO status and risk factors when planning anesthesia induction and emergence. If aspiration of gastric contents occurs, the patient may exhibit a variety of symptoms, with severity based on the volume and pH of the aspirate. Subsequently, patients with observed or suspected aspiration need supportive treatment that varies depending on the severity of symptoms.

Is the nasogastric tube useful to reduce postoperative nausea and vomiting in orthognathic surgery?

2013 ◽  
Vol 30 ◽  
pp. 244-244
Author(s):  
Pulido R. Arellano ◽  
Alonso M.I. Canal ◽  
Quiroga S. Gago ◽  
Pulido M. Arellano ◽  
C. Jimenez de la Fuente ◽  
...  
Keyword(s):  
Nasogastric Tube ◽  
Postoperative Nausea ◽  
Orthognathic Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting

EXPERIENCE OF THE ORGANIZA-TION OF HORSE FEEDING WITH DYSFAGIA CAUSED BY A MYCOSIS OF THE AIRBAG SAC

2020 ◽  
Vol 3 ◽  
pp. 99-104
Author(s):  
O.G. Sharaskina ◽  
◽  
Yu.S. Bgantseva ◽  
Keyword(s):  
Physical Activity ◽  
Nasogastric Tube ◽  
Dry Matter ◽  
Clinical Case ◽  
Cranial Nerves ◽  
Swallowing Function ◽  
Natural Form ◽  
Methods And Techniques ◽  
Nutritional Needs ◽  
Risk Of Aspiration

Organization of feeding sick horses play an important role in the treatment and recov-ery of the animal after the disease. In the case of dysphagia, the use of forced nutrition through a nasogastric tube is required, which makes special demands on the feed used and the form of their supply. The main objective of the study was to analyze the results of the organization of feeding of a horse with dys-phagia caused by mycosis of the air sac with damaged cranial nerves in a specific clinical case and assess the effectiveness of the feed-ing methods and techniques for subsequent use in veterinary practice. In the process of treatment, various methods of preparation and administration of feed and water were used. The most effective method at the be-ginning of treatment (2-3 weeks) was completely enteral feed administration. For the preparation of a mixture for enteral admin-istration, granular compound feeds are well suited that are adopted to the needs of the horse. As the function of swallowing is re-stored, it is possible to transfer to mush, which include concentrates and roughages. The introduction of roughage in its natural form is not advisable until the swallowing function is fully restored, due to the risk of aspiration pneumonia as hay particles can be thrown into the trachea. During the peri-od of treatment and long recovery, the horse may well manage with a minimum amount of dry matter in the diet (up to 1.5% BW), with sufficient intake of energy and protein. In determining the minimum nutritional needs of the horse, one can focus on the feeding standards of non-working horses with minimal physical activity, proposed by the NRC.

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