Enfit™ system nasogastric tube failure

Enfit™ system nasogastric tube failure Nasogastric tube (NGT) insertion is common in the intensive care unit for enteral feeding. However, it is not without procedural complications, including epistaxis and even oesophageal perforation , and severe patient safety incidents have been reported . We recently experienced a case of polyurethane NGT rupture using the new Enfit™ (CORPAK MedSystems, Inc., USA) safety system .We noticed nasogastric feed exuding from a tracheotomy site in a patient who could not swallow safely, and who complained of feeling something trickle down the back of his throat. A chest radiograph (Fig. a) showed the tip of the NGT positioned below the diaphragm, but with two distinct ends in the stomach and duodenum, respectively. The proximal end was withdrawn and revealed a dilated and ruptured tube; the distal tip was removed by endoscopy and showed a dilated ‘aneurysm’ with a blockage distal to the tip, most likely a crushed tablet (Fig. b). The patient suffered no adverse consequences.Chest X‐ray and photographs of Enfit nasogastric tube.We confirmed the potential for rupture by obstructing a fine bore Corflo® 8 mm Enfit tube with a pair of forceps and applying pressure via a compatible 5‐mm syringe of water (Fig. c). Significant pressure (5 cm to 1 cm depression of the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Wiley

Enfit™ system nasogastric tube failure

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Copyright © 2018 The Association of Anaesthetists of Great Britain and Ireland
ISSN
0003-2409
eISSN
1365-2044
D.O.I.
10.1111/anae.14194
Publisher site
See Article on Publisher Site

Abstract

Nasogastric tube (NGT) insertion is common in the intensive care unit for enteral feeding. However, it is not without procedural complications, including epistaxis and even oesophageal perforation , and severe patient safety incidents have been reported . We recently experienced a case of polyurethane NGT rupture using the new Enfit™ (CORPAK MedSystems, Inc., USA) safety system .We noticed nasogastric feed exuding from a tracheotomy site in a patient who could not swallow safely, and who complained of feeling something trickle down the back of his throat. A chest radiograph (Fig. a) showed the tip of the NGT positioned below the diaphragm, but with two distinct ends in the stomach and duodenum, respectively. The proximal end was withdrawn and revealed a dilated and ruptured tube; the distal tip was removed by endoscopy and showed a dilated ‘aneurysm’ with a blockage distal to the tip, most likely a crushed tablet (Fig. b). The patient suffered no adverse consequences.Chest X‐ray and photographs of Enfit nasogastric tube.We confirmed the potential for rupture by obstructing a fine bore Corflo® 8 mm Enfit tube with a pair of forceps and applying pressure via a compatible 5‐mm syringe of water (Fig. c). Significant pressure (5 cm to 1 cm depression of the

Journal

AnaesthesiaWiley

Published: Jan 1, 2018

References

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