Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2006 Jan 7;12(1):114-8.
doi: 10.3748/wjg.v12.i1.114.

Effect of percutaneous endoscopic gastrostomy on gastro-esophageal reflux in mechanically-ventilated patients

Emmanuel E Douzinas  1 , Andreas Tsapalos, Antonios Dimitrakopoulos, Evanthia Diamanti-Kandarakis, Alexandros D Rapidis, Charis Roussos
Affiliations
Randomized Controlled Trial

Effect of percutaneous endoscopic gastrostomy on gastro-esophageal reflux in mechanically-ventilated patients

Emmanuel E Douzinas et al. World J Gastroenterol. .

Abstract

Aim: To investigate the effect of percutaneous endoscopic gastrostomy (PEG) on gastroesophageal reflux (GER) in mechanically-ventilated patients.

Methods: In a prospective, randomized, controlled study 36 patients with recurrent or persistent ventilator-associated pneumonia (VAP) and GER > 6% were divided into PEG group (n = 16) or non-PEG group (n = 20). Another 11 ventilated patients without reflux (GER < 3%) served as control group. Esophageal pH-metry was performed by the "pull through" method at baseline, 2 and 7 d after PEG. Patients were strictly followed up for semi-recumbent position and control of gastric nutrient residue.

Results: A significant decrease of median (range) reflux was observed in PEG group from 7.8 (6.2 - 15.6) at baseline to 2.7 (0 - 10.4) on d 7 post-gastrostomy (P < 0.01), while the reflux increased from 9 (6.2 - 22) to 10.8 (6.3 - 36.6) (P < 0.01) in non-PEG group. A significant correlation between GER (%) and the stay of nasogastric tube was detected (r = 0.56, P < 0.01).

Conclusion: Gastrostomy when combined with semi-recumbent position and absence of nutrient gastric residue reduces the gastroesophageal reflux in ventilated patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Correlation between duration of NGT and mechanical ventilation standing period to the GER rate measured in 70 patients.
Figure 2
Figure 2
Variation of the median GER (%) together with 10%, 25%, 75%, and 90% from pH-metries originated from the sensor located at 20 cm proximally to the lower esophageal sphincter. The symbol in the 48-h period is lacking in patients of non-PEG-group since no pH-metry was performed in that period in this group of patients.
See this image and copyright information in PMC

References

    1. Kingston GW, Phang PT, Leathley MJ. Increased incidence of nosocomial pneumonia in mechanically ventilated patients with subclinical aspiration. Am J Surg. 1991;161:589–592. - PubMed
    1. Pingleton SK, Hinthorn DR, Liu C. Enteral nutrition in patients receiving mechanical ventilation. Multiple sources of tracheal colonization include the stomach. Am J Med. 1986;80:827–832. - PubMed
    1. Torres A, Serra-Batlles J, Ros E, Piera C, Puig de la Bellacasa J, Cobos A, Lomeña F, Rodríguez-Roisin R. Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position. Ann Intern Med. 1992;116:540–543. - PubMed
    1. Bullock TK, Waltrip TJ, Price SA, Galandiuk S. A retrospective study of nosocomial pneumonia in postoperative patients shows a higher mortality rate in patients receiving nasogastric tube feeding. Am Surg. 2004;70:822–826. - PubMed
    1. Ibáñez J, Peñafiel A, Marsé P, Jordá R, Raurich JM, Mata F. Incidence of gastroesophageal reflux and aspiration in mechanically ventilated patients using small-bore nasogastric tubes. JPEN J Parenter Enteral Nutr. 2000;24:103–106. - PubMed

Publication types