A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) as a route for long‐term feeding

Lin, Li‐Chan; Li, Mei-Hui; Watson, Roger

doi:10.1111/j.1365-2702.2010.03541.x

Cited by 45 publications

(42 citation statements)

References 28 publications

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“…There are studies that document frequent use of restraints in acutely ill, hospitalized patients with nasogastric feeding tubes (Kvale et al 2015;Quill 1989). Comparatively, rates are lower with gastrostomy tubes (Ciocon et al 1988;Lin, Li, and Watson 2011). Nasogastric feeding tubes are irritating to the nose and throat.…”

Section: What Are the Burdens Of Tube Feeding?mentioning

confidence: 99%

“…Studies primarily pertain to nasogastric feeding, do not have control groups, and do not specify either the type of or reason for restraint. Three small studies of patients with gastrostomy found that restraint was not common over the long term (Callahan et al 2000;Ciocon et al 1988;Lin, Li, and Watson 2011), and several authors have recommended increased PEG use as a means to reduce restraints in tube-fed patients (Ciocon et al 1988;Mamun and Lim 2005).…”

Section: What Are the Burdens Of Tube Feeding?mentioning

confidence: 99%

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Is Tube Feeding Futile in Advanced Dementia?

Lynch¹

2016

Linacre Q

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It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding. However, presently available guidelines make a single recommendation against tube feeding for all patients. Clinicians, patients, and surrogates should be aware that the guidelines and prior commentary on this topic tend both to overestimate the strength of evidence for futility and to exaggerate the burdens of tube feeding. Shared decision making requires accurate information tailored to the individual patient's particular situation, not blanket guidelines based on flawed data. Lay Summary: Many doctors believe that tube feeding does not help people with advanced dementia. Scientific studies suggest that people with dementia who have feeding tubes do not live longer or gain weight compared with those who are carefully hand fed. However, these studies are not very helpful because of flaws in design, which are discussed in this article. Guidelines from professional societies make a blanket recommendation against feeding tubes for anyone with dementia, but an individual approach that takes each person's situation into account seems more appropriate. Patients and surrogates should be aware that the guidelines on this topic tend both to underestimate the benefit and exaggerate the burdens of tube feeding.

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Section: What Are the Burdens Of Tube Feeding?mentioning

confidence: 99%

Section: What Are the Burdens Of Tube Feeding?mentioning

confidence: 99%

Is Tube Feeding Futile in Advanced Dementia?

Lynch¹

2016

Linacre Q

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“…A multivariate analysis has shown that the main risk factors affecting the one-year survival of PEG patients are summarized as hypoproteinemia, reduced blood lymphocyte count and malignancy-related complications 28. Interestingly, a former survey showed that ‘too old to suffer from an operation’ and leakage were common reasons for patients to refuse PEG 15. However, a study containing 201 patients (age >65) has indicated that old age is not a contraindication of PEG 29.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, leakage was not observed in our study. The reasons that patients refuse to use PEG are associated with the cultural values and education level of patients,15 therefore, it is necessary to state the advantage of PEG for patients in detail.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic efficacy of nutritional support by percutaneous endoscopic gastrostomy in critically ill patients: A self-control clinical trial

Fei¹,

Gao²,

Liu³

et al. 2017

Pak J Med Sci

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Background & Objective:Percutaneous endoscopic gastrostomy (PEG) is a procedure to provide enteral nutrition for critically ill patients. It is commonly used in clinical practice; however, the widespread use of PEG is controversial. Our objective was to evaluate the therapeutic effect of nutritional support by PEG in these critically ill patients.Methods:A total of 64 critically ill patients including 41 males and 23 females (aged 23-84) were identified by the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system during September 2004 to June 2012. The nutritional status before and after PEG was mainly assessed by the tricep skinfold thickness and serum albumin level. The nutritional status and pathological condition were assessed at 4, 8 and 12 weeks before and after PEG feeding. The assessment was according to the classical method of the human nutritional status. Follow-up was performed at one month, three months and 1.5 year after gastrostomy. Statistical analysis was performed by SPSS 11.5 software. The incidence of inhalation pneumonia and gastroesophageal regurgitation was compared by chi square (χ2) test. P<0.05 were considered statistically significant.Results:Among the 64 patients, 9 patients died of their former diseases or related symptoms. Postoperative follow-up showed that both nutritional status and complications were improved after PEG in 55 patients (P<0.05). The serum albumin and tricep skinfold thickness levels were significantly increased. The incidence of hypoglycemia, hypocalcemia, hypokalemia and hyponatremia were lower than pre-operation. The frequencies of complications were significantly reduced. No severe complications occurred in any patient.Conclusions:Our study confirmed that PEG was a good long-term route of nutritional supply with no serious complications for critically ill patients.

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“…(16) Unplanned extubation, which often occurs in restless or uncooperative patients, can lead to repeated replacement of the NG tube, a process which is not only uncomfortable but also potentially risky. (17) According to previous studies, in patients who require long-term use of an NG tube, the most common reason for extubation at home is self-removal (48.8%).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a novel two-piece nasogastric feeding tube for patients with dysphagia

Liu¹,

Yang²,

Wei³

et al. 2013

SMedJ

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A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) as a route for long‐term feeding

Abstract: Investigating patients' perspective on the meaning of 'body' in Taiwanese culture and the decision-making processes related to home enteral tube feeding is recommended for nurses to provide better care and support when home enteral tube feeding in an option.

Cited by 45 publications

References 28 publications

Is Tube Feeding Futile in Advanced Dementia?

Is Tube Feeding Futile in Advanced Dementia?

Therapeutic efficacy of nutritional support by percutaneous endoscopic gastrostomy in critically ill patients: A self-control clinical trial

Feasibility of a novel two-piece nasogastric feeding tube for patients with dysphagia

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