{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:04:30Z","timestamp":1781730270015,"version":"3.54.5"},"reference-count":16,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>A 64-year-old male had an awake right nasal fiber-optic intubation with an endotracheal tube for open reduction and internal fixation of bilateral displaced mandibular fractures. After induction of anesthesia, an 18 Fr nasogastric tube (NGT) was inserted through the left nostril and was secured. The patient required high flow rates to deliver adequate tidal volumes with the ventilator. A chest x-ray done in the postanesthesia care unit revealed a malpositioned NGT in the left lower lobe bronchus, which was immediately removed. The patient was extubated on postoperative day 2. Various traditional methods, such as aspiration of gastric contents, auscultation of gastric insufflations, and chest x-ray are in use to detect or prevent the misplacement of an NGT. These methods can be unreliable or impractical. Use of capnography to detect an improperly placed NGT should be considered in the operating room as a simple, cost-effective method with high sensitivity to prevent possibly serious sequelae of an NGT placed within the bronchial tree.<\/jats:p>","DOI":"10.2344\/13-00021r1.1","type":"journal-article","created":{"date-parts":[[2015,9,23]],"date-time":"2015-09-23T21:56:40Z","timestamp":1443045400000},"page":"114-117","source":"Crossref","is-referenced-by-count":2,"title":["Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery"],"prefix":"10.2344","volume":"62","author":[{"given":"Arun","family":"Kalava","sequence":"first","affiliation":[{"name":"Departments ofAnesthesiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirpal","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Newark Beth Israel Medical Center, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Oral & Maxillofacial Surgery, New York Methodist Hospital, Brooklyn, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel M.","family":"Yarmush","sequence":"additional","affiliation":[{"name":"Departments ofAnesthesiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresita","family":"Lizardo","sequence":"additional","affiliation":[{"name":"Departments ofAnesthesiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i0003-3006-62-3-114-b01","series-title":"Anesth Analg","first-page":"343","article-title":"Esophageal guidewire-assisted nasogastric tube insertion in anesthetized and intubated patients: a prospective randomized controlled study","volume":"114","author":"Kirtania\n              J,","year":"2012","unstructured":"Kirtania\n              J, \n            \n              Ghose\n              T, \n            \n              Garai\n              D, \n            \n              Ray\n              S.\n            \n          \n          Esophageal guidewire-assisted nasogastric tube insertion in anesthetized and intubated patients: a prospective randomized controlled study. Anesth Analg. 2012;114:343\u2013348."},{"key":"i0003-3006-62-3-114-b02","series-title":"Anesthesiology","first-page":"137","article-title":"Oro- and nasogastric tube passage in intubated patients: fiberoptic description of where they go at the laryngeal level and how to make them enter the esophagus","volume":"91","author":"Ozer\n              S,","year":"1999","unstructured":"Ozer\n              S, \n            \n              Benumof\n              J.\n            \n          \n          Oro- and nasogastric tube passage in intubated patients: fiberoptic description of where they go at the laryngeal level and how to make them enter the esophagus. Anesthesiology. 1999;91:137\u2013143."},{"key":"i0003-3006-62-3-114-b03","series-title":"Curr Opin Gastroenterol","first-page":"178","article-title":"Complications related to feeding tube placement","volume":"23","author":"Metheny\n              NA,","year":"2007","unstructured":"Metheny\n              NA, \n            \n              Meert\n              KL, \n            \n              Clouse\n              RE.\n            \n          \n          Complications related to feeding tube placement. Curr Opin Gastroenterol. 2007;23:178\u2013182."},{"key":"i0003-3006-62-3-114-b04","series-title":"JPEN J Parenter Enteral Nutr","first-page":"440","article-title":"Enhancing patient safety during feeding-tube insertion. A review of more than 2000 insertions","volume":"30","author":"Sorokin\n              R,","year":"2006","unstructured":"Sorokin\n              R, \n            \n              Gottlieb\n              JE.\n            \n          \n          Enhancing patient safety during feeding-tube insertion. A review of more than 2000 insertions. JPEN J Parenter Enteral Nutr. 2006;30:440\u2013445."},{"key":"i0003-3006-62-3-114-b05","series-title":"Acta Anaesthesiol Taiwan","first-page":"241","article-title":"Another source of airway-leakage: inadvertent endobronchial misplacement of nasogastric tube in a patient intubated with double-lumen endotracheal tube under anesthesia","volume":"45","author":"Hung\n              MH,","year":"2007","unstructured":"Hung\n              MH, \n            \n              Hsieh\n              PF, \n            \n              Lee\n              SC, \n            \n              Chan\n              KC.\n            \n          \n          Another source of airway-leakage: inadvertent endobronchial misplacement of nasogastric tube in a patient intubated with double-lumen endotracheal tube under anesthesia. Acta Anaesthesiol Taiwan. 2007;45:241\u2013244."},{"key":"i0003-3006-62-3-114-b06","series-title":"J Cardiothorac Vasc Anesth","first-page":"e37","article-title":"Constriction of an endotracheal tube by a nasogastric tube during general anesthesia resulting in pulmonary edema","volume":"26","author":"Lin\n              CS,","year":"2012","unstructured":"Lin\n              CS, \n            \n              Hung\n              CJ, \n            \n              Lin\n              FS, \n            \n              Chan\n              WH.\n            \n          \n          Constriction of an endotracheal tube by a nasogastric tube during general anesthesia resulting in pulmonary edema. J Cardiothorac Vasc Anesth. 2012;26:e37\u2013e38."},{"key":"i0003-3006-62-3-114-b07","series-title":"N Engl J Med","first-page":"1325","article-title":"Accidental pneumothorax from a nasogastric tube","volume":"335","author":"Thomas\n              B,","year":"1996","unstructured":"Thomas\n              B, \n            \n              Cummin\n              D, \n            \n              Falcone\n              RE.\n            \n          \n          Accidental pneumothorax from a nasogastric tube. N Engl J Med. 1996;335:1325."},{"key":"i0003-3006-62-3-114-b08","series-title":"Crit Care Med","first-page":"210","article-title":"Pneumothorax secondary to inadvertent nasotracheal placement of a nasoenteric tube past a cuffed endotracheal tube","volume":"11","author":"Nakao\n              MA,","year":"1983","unstructured":"Nakao\n              MA, \n            \n              Killam\n              D, \n            \n              Wilson\n              R.\n            \n          \n          Pneumothorax secondary to inadvertent nasotracheal placement of a nasoenteric tube past a cuffed endotracheal tube. Crit Care Med. 1983;11:210\u2013211."},{"key":"i0003-3006-62-3-114-b09","series-title":"Cases J","first-page":"6914","article-title":"Inadvertent insertion of a nasogastric tube into both main bronchi of an awake patient: a case report","volume":"2","author":"Takwoingi\n              YM.","year":"2009","unstructured":"Takwoingi\n              YM.\n            \n          \n          Inadvertent insertion of a nasogastric tube into both main bronchi of an awake patient: a case report. Cases J. 2009;2:6914."},{"key":"i0003-3006-62-3-114-b10","series-title":"Crit Care Med","first-page":"892","article-title":"Bronchopleural complications of nasogastric feeding tubes","volume":"14","author":"Hendry\n              PJ,","year":"1986","unstructured":"Hendry\n              PJ, \n            \n              Akyurekli\n              Y, \n            \n              McIntyre\n              R, \n            \n              Quarrington\n              A, \n            \n              Keon\n              WJ.\n            \n          \n          Bronchopleural complications of nasogastric feeding tubes. Crit Care Med. 1986;14:892\u2013894."},{"key":"i0003-3006-62-3-114-b11","series-title":"Crit Care Med","first-page":"2255","article-title":"Use of capnometry to verify feeding tube placement","volume":"30","author":"Araujo-Preza\n              CE,","year":"2002","unstructured":"Araujo-Preza\n              CE, \n            \n              Melhado\n              ME, \n            \n              Gutierrez\n              FJ, \n            \n              Maniatis\n              T, \n            \n              Castellano\n              MA.\n            \n          \n          Use of capnometry to verify feeding tube placement. Crit Care Med. 2002;30:2255\u20132259."},{"key":"i0003-3006-62-3-114-b12","series-title":"Anaesthesia","first-page":"451","article-title":"Confirmation of feeding tube position: how about capnography?","volume":"49","author":"Asai\n              T,","year":"1994","unstructured":"Asai\n              T, \n            \n              Stacey\n              M.\n            \n          \n          Confirmation of feeding tube position: how about capnography?\n          Anaesthesia. 1994;49:451."},{"key":"i0003-3006-62-3-114-b13","series-title":"Crit Care Med","first-page":"936","article-title":"Report of development of a procedure to prevent placement of feeding tubes into the lungs using end-tidal CO2 measurements","volume":"29","author":"Burns\n              SM,","year":"2001","unstructured":"Burns\n              SM, \n            \n              Carpenter\n              R, \n            \n              Truwitt\n              JD.\n            \n          \n          Report of development of a procedure to prevent placement of feeding tubes into the lungs using end-tidal CO2 measurements. Crit Care Med. 2001;29:936\u2013939."},{"key":"i0003-3006-62-3-114-b14","series-title":"J Am Coll Nutr","first-page":"195","article-title":"Confirmation of nasogastric tube placement by calorimetric indicator detection of carbon dioxide: a preliminary report","volume":"17","author":"Thomas\n              BW,","year":"1998","unstructured":"Thomas\n              BW, \n            \n              Falcone\n              RE.\n            \n          \n          Confirmation of nasogastric tube placement by calorimetric indicator detection of carbon dioxide: a preliminary report. J Am Coll Nutr. 1998;17:195\u2013197."},{"key":"i0003-3006-62-3-114-b15","series-title":"Acta Anaesthesiol Scand","first-page":"1245","article-title":"Detection of tracheal malpositioning of nasogastric tubes using endotracheal cuff pressure measurement","volume":"51","author":"Fuchs\n              J,","year":"2007","unstructured":"Fuchs\n              J, \n            \n              Schummer\n              C, \n            \n              Giesser\n              J, \n            \n              Bayer\n              O, \n            \n              Schummer\n              W.\n            \n          \n          Detection of tracheal malpositioning of nasogastric tubes using endotracheal cuff pressure measurement. Acta Anaesthesiol Scand. 2007;51:1245\u20131249."},{"key":"i0003-3006-62-3-114-b16","series-title":"Crit Care","first-page":"25","article-title":"A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes","volume":"2","author":"Rassias\n              AJ,","year":"1998","unstructured":"Rassias\n              AJ, \n            \n              Ball\n              PA, \n            \n              Corwin\n              HL.\n            \n          \n          A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes. Crit Care. 1998;2:25\u201328."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/62\/3\/article-p114.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/62\/3\/114\/2102032\/13-00021r1_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/62\/3\/article-p114.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/62\/3\/article-p114.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:34:03Z","timestamp":1728304443000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/62\/3\/article-p114.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015]]},"references-count":16,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.2344\/13-00021r1.1","relation":{},"ISSN":["0003-3006","1878-7177"],"issn-type":[{"value":"0003-3006","type":"print"},{"value":"1878-7177","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015]]}}}