Underwater-seal nasogastric tube drainage to relieve gastric distension caused by air swallowing.

Air swallowing can occur as a psychogenic phenomenon, because of abnormal anatomy, or during non-invasive positive pressure ventilation. Gross distension of the stomach with air can have severe consequences for the respiratory and gastrointestinal systems. We report the case of a 62-year-old man with severe dynamic hyperinflation due to chronic obstructive pulmonary disease, who developed respiratory failure requiring intubation a few hours after radical prostatectomy. Following a percutaneous tracheostomy and weaning of sedation on day six, his abdomen began to enlarge progressively. X-rays revealed massive gastric distension due to air swallowing, which continued despite all efforts to optimise therapy. The use of an underwater seal drainage system on a nasogastric tube improved ventilation and ultimately aided weaning from mechanical support.
AuthorsA W Solomon, J C Bramall, J Ball
JournalAnaesthesia (Anaesthesia) Vol. 66 Issue 2 Pg. 124-6 (Feb 2011) ISSN: 1365-2044 [Electronic] England
PMID21128904 (Publication Type: Case Reports, Journal Article)
Copyright© 2010 The Authors. Anaesthesia © 2010 The Association of Anaesthetists of Great Britain and Ireland.
Chemical References
  • Water
  • Aerophagy (etiology, therapy)
  • Drainage (instrumentation, methods)
  • Humans
  • Intubation, Gastrointestinal (methods)
  • Male
  • Middle Aged
  • Nasal Cavity
  • Postoperative Care (methods)
  • Prostatectomy
  • Pulmonary Disease, Chronic Obstructive (complications)
  • Ventilator Weaning
  • Water

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