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Eur J Cardiothorac Surg 2006;30:811-812
© 2006 Elsevier Science NL

Case reports

Successful treatment with one-way endobronchial valve of large air-leakage complicating narrow-bore enteral feeding tube malposition

University of Rome "La Sapienza", Department of Surgery and Transplantation "Paride Stefanini", Rome, Italy

Received 23 June 2006; received in revised form 31 July 2006; accepted 7 August 2006.

^_* Corresponding author. Address: University of Rome "La Sapienza", Policlinico Umberto I, Viale del Policlinico 155, 00164 Rome, Italy. Tel.: +39 06 4461971; fax: +39 06 49970735. (Email: tiziano.degiacomo{at}tin.it).

Tracheopulmonary intubation is the most common misplacement site for narrow-bore feeding tube and it might be associated with severe pleuro-pulmonary complications. A 38-year-old female with a severe bilateral pneumonia and acute respiratory insufficiency was admitted in the ICU, intubated, and mechanically ventilated. Few hours after the insertion of a narrow-bore feeding tube the patient's oxygen saturation dropped with hypotension and tachycardia. A large left-side hydropneumothorax developed requiring a chest tube. Air-leakage was important and bronchoscopic implant of one-way endobronchial valve was accomplished. Immediate and substantial decrease of air-leakage was observed, and it completely stopped after 5 days; as soon as the patient was extubated. Endobrochial one-way valve, specifically designed for bronchoscopic lung volume reduction, resulted in being safe and effective to control a significant and prolonged air-leakage due to a malposition of a narrow-bore feeding tube.

Key Words: Pneumothorax • Bronchoscopy • Nutrition