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Routine intragastric feeding following traumatic brain injury is safe and well tolerated
C T Klodell1, M Carroll, E H Carrillo
1Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA.
Insights
Percutaneous endoscopic gastrostomy (PEG) feeding is safe and effective for patients with moderate to severe traumatic brain injury (TBI). This method provides reliable nutrition with a low complication rate, addressing delayed gastric emptying concerns.
Area of Science:
- Neuroscience
- Gastroenterology
- Critical Care Medicine
Background:
- Delayed gastric emptying is common in traumatic brain injury (TBI) patients.
- This often leads to the use of jejunal feeding.
- Percutaneous endoscopic gastrostomy (PEG) feeding is an alternative approach.
Purpose of the Study:
- To review the safety and effectiveness of PEG and intragastric feeding in TBI patients.
- To assess PEG as a reliable method for nutritional support in this population.
Main Methods:
- Patients on a TBI clinical pathway received early PEG placement.
- Standard enteral nutrition was initiated post-PEG.
- Tolerance was assessed via abdominal examination and gastric residual volumes.
Main Results:
- 118 moderate to severe TBI patients were studied (mean age 36, mean ISS 25).
- Intragastric feeding was initiated on day 3 post-PEG.
- 97% of patients tolerated intragastric feeding without complication; 4% experienced complications (e.g., aspiration).
Conclusions:
- PEG offers reliable enteral access for moderate to severe TBI patients.
- Intragastric feeding via PEG is well-tolerated with a low complication rate.
- PEG feeding is an effective nutritional support strategy in TBI management.
Background:
Delayed gastric emptying following traumatic brain injury (TBI) has led some to advocate jejunal feeding. Our purpose was to review our experience with percutaneous endoscopic gastrostomy (PEG) and intragastric feeding in TBI patients to assess safety and effectiveness.
Methods:
All patients on a TBI clinical pathway at our institution were targeted for early PEG. After PEG, standard enteral nutrition was initiated. Abdominal examination and gastric residual volumes were used to assess tolerance.
Results:
There were 118 patients with moderate to severe TBI. The average age was 36 years. Mean Injury Severity Score (ISS) was 25. Enteral access was obtained and intragastric feeding was initiated on day 3. 6. Intragastric feeding was tolerated without complication in 111 of 114 (97%) patients. Five patients aspirated, but had no evidence of intolerance prior to the event.
Conclusions:
PEG provided reliable enteral access in moderate to severe TBI patients. Intragastric feeding was well tolerated with a low complication rate (4%).