Revista nº 801

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86 ORIGINAL
Actualidad
Médica
A C T U A L I D A D
M É D I C A
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Aspirationpneumonia inpatientsunderwent
headandnecksurgery.Acaseseries
Abstrasct
Patients underwent head and neck surgery might present numerous respiratory and gastrointestinal com-
plications. The need to administrate enteral nutrition for long time periods promotes the emergence of
such problems. In this line, is important to underline that these complications could be life threatening for
the patients. The main aim of the present report is to examine the importance of performing a radiographic
control after a NG tubes placement. We firmly believe that it represent the most reliable method to avoid
respiratory complications related with NG tubes in high risk patients.
Resumen
Los pacientes sometidos a cirugía de cabeza y cuello pueden presentar numerosas complicaciones respi-
ratorias y gastrointestinales. La necesidad de administrar la nutrición enteral durante largos períodos de
tiempo promueve la aparición de tales problemas. En esta línea, es importante subrayar que estas com-
plicaciones podrían poner en peligro la vida de los pacientes. El objetivo principal del presente informe
es examinar la importancia de realizar un control radiográfico después de una colocación de tubos NG.
Creemos firmemente que representa el método más fiable para evitar las complicaciones respiratorias
relacionadas con los tubos NG en pacientes de alto riesgo.
Yolanda Baca Morilla1 ; Paolo Cariati2; Almudena Cabello Serrano3; Fernando Monsalve
Iglesias2 ; Dario Sanchez Lopez3
1Anesthesiologist. Hospital Universitario Virgen de las Nieves, Granada (Spain)
2Maxillofacial surgery resident. Hospital Universitario Virgen de las Nieves, Granada (Spain)
3Maxillofacial surgeon. Hospital Universitario Virgen de las Nieves, Granada (Spain)
Enviado: 20-05-2017
Revisado:20-06-2017
Aceptado: 20-07-2017
Keywords: Head and neck
surgery, Aspiration pneumonia,
NG tubes complications,
Radiographic control
Palabras clave: Cirugía de
cabeza y cuello, Neumonía por
aspiración, complicaciones con
tubos NG, Control radiográfico
La neumonía por aspiración en pacientes sometidos
a cirugía de cabeza y cuello. Una serie de casos
Actual. Med.
2017; 102: (801): 86-87
DOI: 10.15568/am.2017.801.or05
Paolo Cariati
Maxillofacial surgery resident.
Hospital Universitario Virgen de las Nieves, Granada (Spain)
E-mail:
INTRODUCTION
Patients underwent head and neck surgery might present
numerous hassles during the immediate postoperative period (1).
Respiratory and gastrointestinal complications are undoubtedly
the most frequent among these (2). In fact, due to the surgical ag-
gression of the upper aero-digestive path is mandatory to adopt
measures of artificial nutrition. Thus, the placement of a NG tube
is almost always required in these patient and it appropriate po-
sitioning is crucial. Life-threatening complication might be pro-
voked by the misplaced of the nasogastric tube in the respiratory
tract (3). In the light of the above, the aim of the present report is
twofold. First, we examine the importance of performing a radio-
graphic control after a NG tube placement in order to reduce the
frequency of these complications. Second, we describe this syn-
drome with the goal of proposing effective preventive measures.
MATERIAL AND METHODS AND RESULTS
Patient 1: 29-year-old man underwent surgical drai-
nage of a neck abscess (dental origin). A cervical approach
was used to reach the submandibular space. A NG tube was
placed due to swallowing problems experienced by patient
during postoperative period. Three days after the NG tube
placement, patient began to present refractory hypoxemia,
tachypnea, fever and leukocytosis. In view of these findings,
we decided to perform a chest x-ray. This test show the pre-
sence of a possible pneumonia. Finally a chest CT confirmed
this diagnosis. Against this backdrop, enteral tube nutrition
was stopped. Moreover, empirical antibiotic treatment was
immediately administered. Fortunately, the patient evolved
favorably and was discharged from intensive care unit 2
weeks later.