Effect of Percutaneous Endoscopic Gastrostomy on Gastro-esophageal Reflux in Mechanically-ventilated Patients

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2006 Jan 28

PMID 16440428

Citations 6

Authors

Emmanuel E Douzinas

Andreas Tsapalos

Antonios Dimitrakopoulos

Evanthia Diamanti-Kandarakis

Alexandros D Rapidis

Charis Roussos

Affiliations

Soon will be listed here.

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.

Citing Articles

Comparison Between Percutaneous Endoscopic Gastrostomy and Nasogastric Feeding in 160 Patients with Swallowing Disturbances: A Two-Year Follow-Up Study.

Du G, Liu F, Ma X, Chen S, Dai M, Wei L Clin Interv Aging. 2022; 17:1803-1810.

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Percutaneous endoscopic gastrostomy feeding effects in patients with neurogenic dysphagia and recurrent pneumonia.

Lee J, Kwon H, Kwon K, Park S, Suh Y, Kim J Ther Adv Respir Dis. 2021; 15:1753466621992735.

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How should this patient with repeated aspiration pneumonia be managed and treated?-a proposal of the Percutaneous ENdoscopIc Gastrostomy and Tracheostomy (PENlIGhT) procedure.

Zhang Z, Akulian J, Hong Y, Liu N, Chen Y J Thorac Dis. 2017; 8(12):3720-3727.

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Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances.

Gomes Jr C, Andriolo R, Bennett C, Lustosa S, Matos D, Waisberg D Cochrane Database Syst Rev. 2015; (5):CD008096.

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Esophageal obstruction due to enteral feed bezoar: A case report and literature review.

Marcus E, Arnon R, Sheynkman A, Caine Y, Lysy J World J Gastrointest Endosc. 2010; 2(10):352-6.

PMID: 21160586 PMC: 2998820. DOI: 10.4253/wjge.v2.i10.352.

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