Acutely unwell patients are preferably fed through fine bore nasogastric tubes,

provided they do not require gastric decompression with a larger Ryle's tube

This is because fine bore tubes are more easily tolerated

Large bore tubes are associated with rhinitis, oesophageal reflux and

strictures (1)

However, this tolerance comes at a price - patients may tolerate accidental

intubation of the trachea and bronchi without obvious distress (2)

If the tube misplacement is not spotted, and feeding is commenced, the

consequences can be serious, including (3)

Pneumothorax

Severe pneumonia

Empyema

Pulmonary haemorrhage

Death, depending on response to the above

1. Pearce CB, Duncan HD. Postgrad Med J 2002;78(918):198-204

2. de Aguilar-Nascimento JE, Kudsk KA. Curr Opin Clin Nutr Metab Care. 2007 May;10(3):291-6

3. Kawati R, Rubertsson S. Acta Anaesthesiol Scand 2005; 49(1):58-61