Percutaneous endoscopic gastrostomy for critically ill patients in a general intensive care unit

Abstract

Background and aim: percutaneous endoscopic gastrostomy (PEG) is an effective way of providing enteral feeding to patients with functionally normal gastrointestinal tract who cannot meet their nutritional needs because of inadequate oral intake. This retrospective study evaluated the clinical outcome of critically ill patients with high assistance level undergoing PEG in a general ICU over a 12 year period.

Patients and methods: we studied a cohort of 82 patients who underwent PEG over a 12-year period between 1 January 1999 and 31 December 2010. Patients were followed-up for 1 year after PEG placement.

Results: There were no complications related either to the procedure or to the management of PEG, even in house nursing.In one patient, PEG with a collapsible bumper was successfully removed because the patient fully recovered from his neurological problem. Catheter substitution was necessary in three patients during the first year, because of stoma inflammation due to enteric reflux between the stoma and the catheter. One year after PEG, 66 patients were still alive while 16 patients died from the underlying disease during hospitalization. None of the patients with PEG had aspiration pneumonia.

Conclusions: PEG, in expert hands, is a safe and effective procedure for enteral nutrition. Moreover, catheters should be chosen in relation to the duration of enteral feeding and as to whether the patient is likely to recover from his underlying disease.