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

Abstract

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.

Gastrostomy tubes appear to be safe following pediatric orthotopic heart transplant

“…While it is reasonable to consider prophylactic GT placement prior to initiation of immunosuppressive medications, data from (PEG) tube placement in oncology patients showed no difference in complication rates regarding timing of placement . Use of GTs in other critically ill adult patient populations such as after cerebral hemorrhage or infarction has also been shown to be safe and effective with complication rates comparable to that of the general population . Overall complication rates in adults 30 days after conventional pull‐type PEG procedure range from 16% to 39% .…”

“…30 Use of GTs in other critically ill adult patient populations such as after cerebral hemorrhage or infarction has also been shown to be safe and effective with complication rates comparable to that of the general population. 31 Overall complication rates in adults 30 days after conventional pull-type PEG procedure range from 16% to 39%. 32 This study has several limitations.…”

Percutaneous endoscopic gastrostomy experience in children and family satisfaction

“…One of the reasons for this is that there are difficulties with the measurement of height due to neuromuscular and genetic disorders present in the majority of children undergoing PEG. It has been reported that measurements such as UMAC and TST provide more accurate information in the growth monitoring of these patients 10,11 . We also used TST and UMAC measurements besides standard measurements in this patient group.…”

Role of feeding procedures in upper gastro-intestinal malignancy patients undergoing radiotherapy

“…9 The In a study by Zhou et al, the triceps skinfold thickness and serum albumin level significantly increased at 4 th , 8 th and 12 th week after gastrostomy. 11 In another retrospective study where gastrostomy was done in head and neck cancer patients, the nutritional parameters like weight, BMI and serum albumin did not improve at 3, 6 and 12 months after gastrostomy. 12 In our present study also the BMI, serum albumin and the nutrition score did not improve significantly after the FG procedure.…”