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Duodopa nasoduodenal tube at intrabronchial position
Sonda nasoduodenal de duodopa en localización endobronquial
I. Albero Roselló
, E. Romero García, I. Gimenez Jimenez, P. Argente Navarro
Corresponding author
Servicio Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Albero Roselló, E. Romero García, I. Gimenez Jimenez, P. Argente Navarro" "autores" => array:4 [ 0 => array:4 [ "nombre" => "I." "apellidos" => "Albero Roselló" "email" => array:1 [ 0 => "nachoalbero@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Romero García" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Gimenez Jimenez" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Argente Navarro" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario y Politécnico La Fe, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sonda nasoduodenal de duodopa en localización endobronquial" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 100456 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Position of the tube in the lung. The passage of the tube through the vocal cords is marked with an asterisk.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">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, SpO<span class="elsevierStyleInf">2</span>, 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<span class="elsevierStyleHsp" style=""></span>°<span class="elsevierStyleSmallCaps">C</span>) and the need for Boussignac CPAP ventilation with O<span class="elsevierStyleInf">2</span> at 8<span class="elsevierStyleHsp" style=""></span>lpm to maintain SpO<span class="elsevierStyleInf">2</span> 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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Rev Esp Anestesiol Reanim. 2018;65:480–481.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0015" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0010" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1626 "Ancho" => 1583 "Tamanyo" => 213746 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Poor-quality anteroposterior radiograph that does not clearly show the location of the nasoduodenal tube due to a large hiatus hernia.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 100456 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Position of the tube in the lung. 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