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Safety of percutaneous endoscopic gastrostomy in medically complicated infants

Philip Minar1, Jeffery Garland, Alfonso Martinez

  • 1Divisions of Gastroenterology and Perinatology, Department of Pediatrics, Wheaton Franciscan Health Care-St Joseph's Regional Hospital, Children's Hospital of Wisconsin, and the Medical College of Wisconsin, Milwaukee, WI, USA.

Journal of Pediatric Gastroenterology and Nutrition
|August 26, 2011
PubMed

Insights

Percutaneous endoscopic gastrostomy (PEG) tube placement is safe and feasible for small, medically complicated infants. This study found a low complication rate in infants under 6 kg, supporting its use for nutritional support.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatal Intensive Care
  • Minimally Invasive Procedures

Background:

  • Percutaneous endoscopic gastrostomy (PEG) tubes are vital for nutritional support in children unable to feed orally.
  • Limited data exists on PEG safety in small infants, particularly those with complex medical conditions.
  • Previous studies report major complication rates for PEG placement ranging from 0.5% to 17% in general pediatric populations.

Purpose of the Study:

  • To assess the incidence of acute complications associated with PEG placement in medically complicated infants weighing less than 6 kg.
  • To evaluate the feasibility and safety of PEG procedures in this specific high-risk infant population.

Main Methods:

  • Retrospective chart review of infants (<6 kg) who underwent PEG placement between January 2001 and June 2008.
  • Inclusion criteria focused on infants within the Neonatal Intensive Care Unit (NICU) setting.
  • Data collection included gestational age, weight, indication for PEG, procedural success, and complications.

Main Results:

  • Forty infants (mean gestational age 29 weeks, mean weight 3250 g) were included.
  • Successful PEG placement was achieved in 95% (38/40) of infants.
  • One major complication (pneumomediastinum) and one instance of inability to pass the PEG bumper were recorded. Sixteen infants had concurrent surgical procedures.

Conclusions:

  • Percutaneous endoscopic gastrostomy (PEG) placement is a feasible and safe intervention for small, medically complex infants requiring nutritional support.
  • The study demonstrates a low rate of major complications in this vulnerable population.
  • PEG insertion can be safely performed in the NICU setting for infants unable to feed orally.
Abstract

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