Abstract
Background & Objective:Percutaneous endoscopic gastrostomy (PEG) is a procedure to provide enteral nutrition for critically ill patients. It is commonly used in clinical practice; however, the widespread use of PEG is controversial. Our objective was to evaluate the therapeutic effect of nutritional support by PEG in these critically ill patients.Methods:A total of 64 critically ill patients including 41 males and 23 females (aged 23-84) were identified by the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system during September 2004 to June 2012. The nutritional status before and after PEG was mainly assessed by the tricep skinfold thickness and serum albumin level. The nutritional status and pathological condition were assessed at 4, 8 and 12 weeks before and after PEG feeding. The assessment was according to the classical method of the human nutritional status. Follow-up was performed at one month, three months and 1.5 year after gastrostomy. Statistical analysis was performed by SPSS 11.5 software. The incidence of inhalation pneumonia and gastroesophageal regurgitation was compared by chi square (χ2) test. P<0.05 were considered statistically significant.Results:Among the 64 patients, 9 patients died of their former diseases or related symptoms. Postoperative follow-up showed that both nutritional status and complications were improved after PEG in 55 patients (P<0.05). The serum albumin and tricep skinfold thickness levels were significantly increased. The incidence of hypoglycemia, hypocalcemia, hypokalemia and hyponatremia were lower than pre-operation. The frequencies of complications were significantly reduced. No severe complications occurred in any patient.Conclusions:Our study confirmed that PEG was a good long-term route of nutritional supply with no serious complications for critically ill patients.
Highlights
Numerous conditions may compromise the passage of food along the digestive tract, such as severe head injury, brain tumors, cranial encephalic trauma, cerebral hemorrhage and cerebral infarction.[1]
The nutritional support by intravenous pathway or nasogastric tube (NG) was discontinued after percutaneous endoscopic gastrostomy (PEG)
Among the 64 patients, 9 patients died of their former diseases or related symptoms, such as head trauma, intracranial hemorrhage or malignant tumors; three patients were lost to follow-up after recovery
Summary
Numerous conditions may compromise the passage of food along the digestive tract, such as severe head injury, brain tumors, cranial encephalic trauma, cerebral hemorrhage and cerebral infarction.[1] Because of the impairment or dysfunction of gag reflex; they are unable to ingest food orally For these critically ill patients, enteral nutrition support is an important part. Percutaneous endoscopic gastrostomy (PEG) is a procedure to provide enteral nutrition for critically ill patients. It is commonly used in clinical practice; the widespread use of PEG is controversial. Conclusions: Our study confirmed that PEG was a good long-term route of nutritional supply with no serious complications for critically ill patients
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