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Complications of small-bore feeding tubes: is newer technology necessarily better?
  1. Yesica Campos1,2,
  2. Claire Kerin3,
  3. Ranier Reyes1,2
  1. 1Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  2. 2Department of Neurosurgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  3. 3Department of Neuroscience ICU, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Dr Ranier Reyes; ranier.reyes{at}utsouthwestern.edu

https://doi.org/10.1136/tsaco-2020-000572

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    Dear editor,

    Jacobson et al1 keenly examined how a novel electromagnetic tracking system may be safely used to ensure correct placement of small-bore feeding tubes (SBFTs). Clinical practice has shifted such that SBFTs are preferred for short-term feeding due to a reduction in aspiration risk and perceived patient comfort.2 The latter, however, is largely anecdotal and may reflect provider perception rather than reality. In actuality, traditional large-bore feeding tubes (LBFTs) may be the favorable option.

    SBFTs are commonly placed blindly with a 1%–3% incidence of erroneous airway insertion. A pneumothorax occurs in one-third of pulmonary misplacements with an associated mortality rate reportedly exceeding 20%. Additional pulmonary complications include hemothoraces, pneumonias and broncho-pleural fistulas.1 3 SBFTs employ a rigid guidewire—the suspected culprit …

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