Tracheobronchial malposition of fine bore feeding tube in patients with mechanical ventilation 英文参考文献.docVIP

Luo et al. Critical Care 2011, 15:454 /content/15/6/454 LETTER Tracheobronchial malposition of ? ne bore feeding tube in patients with mechanical ventilation Ru-Bin Luo, Mao Zhang* and Jian-Xin Gan e increasing prevalence of the use of enteral feeding rigidity of the feeding tube, which may be easy to pass tubes during critical illness leads to the increased through the space between the tracheal wall and in? ated potential for malposition of the tube [1], which may cu? . It has been advised to monitor the pressure of the result in severe complications. We report tracheo- endotracheal tube’s cu? during insertion [3]. Neither bronchial malposition of feeding tubes in six mecha- auscultation of bubbling sounds from the epigastrium nically ventilated patients. after insu? ation of air nor aspiration of ‘gastric content’ is thought to be reliable. Measuring the level of carbon From January 2008 to August 2011, six multiple trauma patients with mechanical ventilation in the emergency dioxide in the feeding tube is a simple way to con? rm ICU were included in this study ey were male, aged 20 trachebronchial malpo e UK National Patient to 84 years, with an injury severity score (ISS) of 29 to 41. Five patients were intubated and one underwent tracheo- tomy. Insertion of a ? ne bore feeding tube (CH10 CM145 Bengmark naso-intestimal tube, Nutricia Medical Devices BV, Switzerland) was tried 1 to 3 days after ICU Safety Agency has requested pH testing of gastric aspirate be used as the ? rst line method for testing trachebronchial malposition, with pH between 1 and 5.5 as the safe range [5]. X-rays are used as a second line test when all the above methods have failed to con? rm the e ? rst patient had intermittent cough accom- position. Caution should be taken when interp