Related Experiment Videos
[Percutaneous endoscopic gastrostomy in the ICU]
I O Akinci1, P Ozcan, S Tuğrul
1I.U. Istanbul Tip Fak. Anesteziyoloji ve Reanimasyon A.D. Monoblok 34390 Capa, Istanbul.
Abstract:
Aspiration pneumonia due to gastroesophageal reflux is a frequent complication in ICU. The most commonly chosen method for long-term enteral access is gastrostomy and this method also reduces the risk of aspiration and shortens the hospital stay. We evaluated 31 patients in whom PEG was performed between 1997-98 in our unit. Indication of PEG was long-term ICU stay and coma which necessitate long term enteral nutrition. Mean age of our patients were 60.5((19.4). We evaluated the aspiration by clinical inspection. Aspiration and interruption of feeding was observed 1.57 ((1.43) times before PEG and 0.67 ((0.73) times after PEG. Further more positive tracheal aspirate culture were seen 3.14 ((1.95) times before PEG and 1.52 ((1.47) times after PEG.
Insights
Percutaneous endoscopic gastrostomy (PEG) reduces aspiration events and positive tracheal cultures in ICU patients requiring long-term enteral nutrition. This procedure improves outcomes for patients with gastroesophageal reflux and coma.
Area of Science:
- Medicine
- Gastroenterology
- Intensive Care Medicine
Background:
- Aspiration pneumonia is a common complication in intensive care units (ICUs).
- Gastroesophageal reflux frequently leads to aspiration pneumonia.
- Long-term enteral nutrition is often required for patients with prolonged ICU stays and coma.
Purpose of the Study:
- To evaluate the effectiveness of percutaneous endoscopic gastrostomy (PEG) in reducing aspiration.
- To assess the impact of PEG on feeding interruptions and tracheal aspirate cultures.
- To determine if PEG shortens hospital stay and reduces the risk of aspiration in ICU patients.
Main Methods:
- Retrospective evaluation of 31 patients who underwent PEG between 1997-1998.
- Indication for PEG was long-term ICU stay and coma necessitating enteral nutrition.
- Aspiration events, feeding interruptions, and positive tracheal aspirate cultures were assessed before and after PEG placement.
Main Results:
- Aspiration and feeding interruptions decreased from 1.57 to 0.67 events post-PEG.
- Positive tracheal aspirate cultures reduced from 3.14 to 1.52 instances after PEG.
- PEG placement was associated with a reduction in aspiration-related complications.
Conclusions:
- Percutaneous endoscopic gastrostomy is an effective method for long-term enteral access in ICU patients.
- PEG significantly reduces the incidence of aspiration and associated complications.
- PEG improves outcomes for critically ill patients requiring prolonged enteral nutrition.