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A randomized prospective trial of immediate vs. next-day feeding after percutaneous endoscopic gastrostomy in

Jurgen Stein1, Arnd Schulte-Bockholt, Marion Sabin

  • 1Medizinische Klinik II, Johann-Wolfgang-Goethe Universität, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. j.stein@em.uni-frankfurt.de

Intensive Care Medicine
|November 5, 2002
PubMed

Insights

Starting enteral feeding immediately after percutaneous endoscopic gastrostomy (PEG) is safe for critically ill patients. This approach shows no increased complications or mortality compared to initiating feeding the next day.

Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Clinical Nutrition

Background:

  • Early enteral nutrition is crucial for critically ill patients.
  • Percutaneous endoscopic gastrostomy (PEG) provides a route for enteral feeding.
  • The optimal timing for initiating feeding post-PEG remains a subject of investigation.

Purpose of the Study:

  • To compare the clinical outcomes of immediate versus next-day enteral feeding after PEG placement.
  • To assess the safety and efficacy of early post-PEG feeding in intensive and intermediate care settings.

Main Methods:

  • A prospective, randomized controlled trial was conducted in two German hospitals.
  • Eighty patients were randomized into two groups: immediate feeding (within 1 hour) and next-day feeding (24 hours post-PEG).
  • Patients received a standardized polymeric formula, and gastric residual volumes were monitored for 72 hours.

Main Results:

  • The immediate feeding group showed a transient increase in gastric residual volumes on day 2, but no significant differences in overall complication rates were observed.
  • No significant differences in short-term (1-3 days) or long-term (1-30 days) mortality were found between the groups.
  • Gastric residue volumes did not significantly differ between immediate and next-day feeding groups.

Conclusions:

  • Immediate enteral feeding via PEG is a safe strategy for acutely ill intensive and intermediate care patients.
  • Initiating feeding within 1 hour post-PEG does not increase adverse events or mortality compared to next-day feeding.
  • This finding supports the early initiation of nutritional support in critically ill patients requiring PEG.
Abstract

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