Percutaneous endoscopic gastrostomy in neurology intensive care unit

İnanç, Yılmaz; Gokce, Mustafa; Tuncel, D. Ay; İnanç, Yusuf; Demirhan, Sabriye Özçekiç; Bavli, Songül

doi:10.5455/ijsm.percutaneous-endoscopic-gastrostomy-neurology

Cited by 4 publications

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References 7 publications

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“…On the other hand, many studies reported infection as the most common complication with rates around 20-30% of the cases [31,33,35], which is similar to our results. In some older studies, it was reported to be as high as 65% [36,37].…”

Section: Discussionsupporting

confidence: 92%

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Attitude and experience of neurologists towards percutaneous endoscopic gastrostomy: an Egyptian study

Farag

Georgy

Fathy

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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Background Dysphagia is a common symptom among various neurological diseases. Guidelines recommend gastrostomy insertion for prolonged dysphagia with lower rate of intervention failure encountered with percutaneous endoscopic gastrostomy (PEG) as compared to nasogastric tube insertion. Methods Neurology consultants only were included and completed a self-administered questionnaire concerning their practice backgrounds and previous experience with PEG feeding during their practice. Results Ninety-eight percent stated that they would recommend PEG for patients with prolonged need of nasogastric feeding. However, only 88% actually referred patients to perform PEG, with the cerebrovascular disorders being the most common cases to be referred. The main barriers the surveyed neurologists faced were family resistance and financial reasons (53.5%). Interestingly, younger neurologists practicing for less than 15 years referred patient to perform PEG significantly more frequent than older ones (p = 0.01). About 18% of our sample confirmed the lack of sufficient knowledge about the benefits of PEG feeding, and only 22% previously attended scientific sessions about the benefits and indications of PEG. Conclusion Based on our study, we recommend that PEG should be more encouraged in indicated neurological cases. Scientific sessions targeting neurologists and public awareness about the benefits of PEG and its relatively infrequent complications are highly demanded.

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Section: Discussionsupporting

confidence: 92%

“…In some older studies, it was reported to be as high as 65% [36,37]. Once again, mild redness around the tube insertion site is common due to tube movement which is considered acceptable; however, more severe redness, purulent discharge, and signs of systemic infection must raise the possibility of wound infection [26,[32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Attitude and experience of neurologists towards percutaneous endoscopic gastrostomy: an Egyptian study

Farag

Georgy

Fathy

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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“…Infection complications have been reported in 36% of patients staying more than 48 hours in ICU [3].Changes in consciousness in patients in Neurology ICU increase the risk of aspiration pneumonia and other infections with the need for nasogastric catheter and the application of percutaneous endoscopic gastrostomy. Invasive interventions such as the application of mechanical ventilation, tracheostomy and catheter, the use of broad-spectrum antibiotics and the length of stay in ICU are significant reasons for the development of difficult-to-treat infections with resistant pathogens in ICU [4].…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the infection agents and the demographic characteristics of patients followed up on a mechanical ventilator in neurology intensive care: A retrospective, single center, observational study

İnanç¹,

İnanç²

2018

Journal of Surgery and Medicine

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How to cite / Atıf için: İnanç Y, İnanç Y. An evaluation of the infection agents and the demographic characteristics of patients followed up on a mechanical ventilator in neurology intensive care: A retrospective, single center, observational study.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractAim: The incidence of nosocomial infections is higher than other sites of the hospitals at intensive care units (ICU) because of high frequency of invasive interventions and multidrug resistant microorganism's prevalence. Ventilator-related pneumonia cases have the highest mortality risk among the nosocomial infections. The aim of this study was to evaluate the endotracheal aspirate cultures and the demographic characteristics of patients followed up on mechanical ventilation in Neurology Intensive Care. Methods: Our study was designed as a retrospective, cross-sectional and descriptive. Retrospective evaluation was made of 51 patients who were attached to a mechanical ventilator in the last 6 months and from whom a tracheal aspirate culture was taken.The endotracheal aspirate samples were taken under sterile conditions using a specifically designed catheter with the method of administering saline into the intubation tube and then aspiration. Blood culture results sent for analysis at the same time as the tracheal aspirate samples were also retrospectively evaluated in patients determined with positive production. A record was made of the demographic characteristics of the patients, diagnosis on admittance to ICU, risk factors, and microbial production in the tracheal aspirate culture. Results: In the first culture, there was no production in 22 (43.1%) cases, and Acinetobacter baumanii was determined in 14 (27.5%) patients, Pseudomonas aeruginosa in 3 (5.9%), Klebsiella pneumonia in 3 (5.9%), Staphylococcus aureus in 2 (3.9%), Corynebacterium striatum in 2 (3.9%), Acinetobacter baumanii + Pseudomonas aeruginosa in 2 (3.9%), Acinetobacter baumanii + Klebsiella pneumonia in 2 (3.9%), and Acinetobacter baumanii + Escherichia coli in 1 (2.0%). The second culture was taken from patients on the mean 11th day. In 3 (10.7%) patients there was no production in the second culture and in the other patients, Acinetobacter baumanii was determined in 15 (53.6%) patients, Pseudomonas aeruginosa in 3 (10.7%), Klebsiella pneumonia in 2 (7.1%), Escherichia coli in 1 (3.6%), Corynebacterium striatum in 1 (3.6%), and Acinetobacter baumanii + Pseudomonas aeruginosa in 3 (10.7%). Conclusion: The culture results in this study of patients admitted for neurological reasons were observed to be consistent with findings in literature. The high mortality rate of 64.7% in these ICU patients is due to the majority being ischemic stroke patients. This sugge...

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“…[8,9] YBÜ'de takip edilen hastaların komorbid hastalıkları, metabolik sorunla-rı, düşük immün kondisyon, bilinç değişikliği gibi kompleks sorunlarıyla beraber artmış invaziv işlemler, üriner kateterizasyon, uzun süreli periferik ve satral venöz kateterizasyon, endotrakeal tüp kullanımı HE gelişim riskini arttırmaktadır. [8,10,11] YBÜ'de takip edilen hastalar için HE morbidite ve mortalitenin en önemli belirleyicisidir; HE etkenlerini ve antibiyotik duyarlılıklarını belirlemek mortalitenin azaltılması açısından önemlidir. [1,3] Çalışmamızda NYBÜ'de yatan hastalarda mortalite %27,15 (63), HE gelişen grupta ise mortalite %56,66 (17), HE gelişmeyen grupta %22,7 (46) olarak saptanmıştır.…”

Section: Discussionunclassified

Bir Üniversite Hastanesi Noroloji Yoğun Bakım Ünitesinde Gelişen Enfeksiyonların Değerlendirilmesi

Şahin¹,

Yıldız²,

Topal³

et al. 2019

Journal of Contemporary Medicine

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Bir üniversite hastanesi noroloji yoğun bakım ünitesinde gelişen enfeksiyonların değerlendirilmesi Evaluation of nosocomial infections in a neurological intensive care unit of a university hospital Amaç: Hastane enfeksiyonları (HE) sıklığı, uzamış yaşam, gelişen teknoloji, artmış invaziv girişimler ve uzamış yatış nedeniyle giderek artmaktadır. Yoğun bakım üniteleri (YBÜ) HE'nin en sık görüldüğü hastane birimleridir. Nöroloji YBÜ (NYBÜ)'de gelişen HE'ler altta yatan primer hastalıklar, genel durum bozukluğu, artmış invaziv işlemler sebebi ile artmış mortaliteye yol açar. Bu çalışmada NYBÜ'de bir yıl içinde invaziv alet kullanımı gelişen enfeksiyonları, izolatlarını değerlendirmeyi planladık. Gereç ve Yöntem: Çalışmaya 2017 yılı içerisinde takip edilen 232 hasta alınmış, enfeksiyon kontrol komitesi (EKK) hemşireleri ve Enfeksiyon Hastalıkları Anabilim Dalı'nca NYBÜ'ne gerçekleştirilen vizitlerde HE tanısı almış hastalar, izolatlar, direnç profilleri, tutulum tanımları incelenmiştir. Bulgular: Çalışmamızda NYBÜ'de yatan hastalarda mortalite %27,15, HE gelişen grupta ise mortalite %56,66 olarak bulunmuştur. En sık görülen enfeksiyon %43,3 ile ventilatör ilişkili pnömoni (VIP) en sık etken ise %28,9 ile Acinetobacter baumannii saptanmıştır. Sonuç: NYBÜ'de EKK'nın sık rastlanan nozokomiyal patojenlerin yayılma ve bulaşmasına karşılık alacağı tedbirlere uyum sağlamak, standart önlemlere ve el hijyenine riayet etmek ve gereksiz invaziv alet kullanımından kaçınmak gerekmektedir. Enfeksiyon oran ve hızları değerlendirilmeli, ulusal sürveyans verileri ile karşılaştırılmalıdır. Sık karşılaşılan patojenler ve antibiyotik direnç özelliklerinin iyi tanımlanması ampirik tedavinin uygun ve vaktinde başlanmasında, morbidite ve mortalite azalmasında önemlidir. Anahtar Sözcükler: Enfeksiyon; enfeksiyon Kontrol; yoğun bakım ünitesi. Introduction: The frequency of nosocomial infections (NI) are gradually increasing because of prolonged life, advancing technology, increasing invasive procedures. NI are mostly seen in intensive care units. NI, developed in neurology intensive care unit (NICU), lead to increased mortality because of underlying primer diseases, general medical condition disorder, and increased invasive operations. In this study, we aimed to evaluate the use of invasive instrument,developing infections,and isolations in a year. Methods: 232 patients (followed in 2017) are included in this study. Patients diagnosed with NI, isolates, resistance profiles, and involvement are examined in the visits to NICU by the nurses of infection control committee(ICC) and the Department of Infectious Diseases. Results: In our study, the mortality in NICU patients is %27,15 and in NI group the mortality is %56,66. The most common infection is ventilator-associated pneumonia with %43,3 (VAP) and the most common factor is Acinetobacter baumannii with %28,9. Discussion and Conclusion: It is necessary to coordinate with precautions (taken by ICC) against to extension and contagion of common nosocomial pathogens, to consider standart precautio...

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Percutaneous endoscopic gastrostomy in neurology intensive care unit

Cited by 4 publications

References 7 publications

Attitude and experience of neurologists towards percutaneous endoscopic gastrostomy: an Egyptian study

Attitude and experience of neurologists towards percutaneous endoscopic gastrostomy: an Egyptian study

An evaluation of the infection agents and the demographic characteristics of patients followed up on a mechanical ventilator in neurology intensive care: A retrospective, single center, observational study

Bir Üniversite Hastanesi Noroloji Yoğun Bakım Ünitesinde Gelişen Enfeksiyonların Değerlendirilmesi

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