Influence of percutaneous gastrostomy-jejunostomy on the incidence of ventilation-associated pneumonia in critically ill patients

Abstract

Objective To explore the influence of percutaneous gastrostomy-jejunostomy (PEG-J) on the nutritional status and prognosis of critically ill patients in ICU. Methods Totally 58 patients who received mechanical ventilation in the ICU of Changshu No.1 People's Hospital from January 2013 to December 2015 were divided into two groups according to random number table: treatment group (n=28, enteral nutrition by establishing PEG-J tube in 120 hours after excluding contraindications); and control group (n=30, nasogastric tube as the way of giving enteral nutrition and if delayed gastric emptying happened, nasogastric tube would be replaced by nasointestinal tube). The incidence of ventilation-associated pneumonia (VAP) within 28 days, duration of ICU stay, and duration of mechanical ventilation were compared between these two groups. Results The incidence of 28-day VAP(7.14% vs. 26.67%, P=0.049), duration of ICU stay[(13.6±5.9)d vs. (16.8±4.4)d, P=0.024], duration of mechanical ventilation[(8.1±5.0)d vs. (10.7±4.5)d, P=0.041] were significantly lower or shorter in treatment group than in control group. Conclusions The use of PEG-J tube for enteral nutrition in critically ill patients is reliable and safe. It also helps to reduce VAP. Key words: Pneumonia, ventilator-associated; Percutaneous gastrostomy-jejunostomy; Duration of ICU stay; Duration of mechanical ventilation