Duodopa nasoduodenal tube at intrabronchial position

Albero Roselló, I.; Romero García, E.; Gimenez Jimenez, I.; Argente Navarro, P.

doi:10.1016/j.redare.2018.08.001

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The passage of the tube through the vocal cords is marked with an asterisk." ] ] ] "textoCompleto" => "A 73-year-old patient with a history of arterial hypertension, atrial fibrillation, scoliosis and advanced Parkinson's disease was admitted for scheduled percutaneous endoscopic gastrostomy (PEG) for the administration of duodopa. Forty-eight hours prior to PEG, a nasoduodenal tube was inserted to verify the efficacy of treatment. Insertion was complicated. Correct placement of the tube could not be radiologically confirmed due to poor image quality (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>); despite this, duodopa infusion was started. Before start of the PEG procedure, basic monitoring was performed (EKG, SpO2, NIBP), but results were suboptimal due to the patient's dyskinesia. The patient was sedated with TCI of low-dose remifentanil and propofol. Upper gastrointestinal endoscopy showed that the nasoduodenal tube was positioned in the airway (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), so it was decided to remove it under direct vision, which was accompanied by the loss of abundant material. It was decided to interrupt the procedure and take stock of the situation, so the patient was transferred to the post-anaesthesia care unit with fever (38.7°C) and the need for Boussignac CPAP ventilation with O2 at 8lpm to maintain SpO2 above 95%. Left basal consolidation was found on a subsequent radiograph. The initial respiratory insufficiency was resolved and follow-up radiographs also showed improvement. 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ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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Vol. 65. Issue 8.