Immediate Tube Feeding after Percutaneous Endoscopic Gastrostomy: Early Return to Goal Tube Feeds without Added Complications.

Q4 Medicine Connecticut Medicine Pub Date : 2017-02-01

Laura C Lamb, Vijay Jayaraman, Stephanie C Montgomery, Affan Umer, David S Shapiro, James M Feeney

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Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) is frequently performed for delivery of nonoral enteral nutrition (EN) in critically ill patients. Tube-based supplement initiation is often delayed for a variety of reasons despite evidence that EN interruption results in worse outcomes.

Objective: To determine if early initiation of EN after PEG placement is safe and well-tolerated in critically ill patients and if early initiation of EN results in more goal-accomplished days of EN.

Design: A retrospective chart review of patients who underwent PEG and at least 24 hours of EN. Patients were stratified according to time to tube- feed initiation: immediate (< one hour), early (one to four hours), and late (four to 24 hours).

Results: 'Ihe three groups were similar with respect to demographics, comorbidities, and 30-day mortality. Sixty-one percent of patients in the immediate group were advanced to the previously-met goal EN rates compared to 24% and 18% in the early and delayed groups, respectively (P < .0001).

Conclusion: Immediate reinitiation of nonoral EN after PEG procedure is safe and is associated with reaching goal nutrition faster.

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经皮内镜胃造口术后立即管饲:早期返回目标管饲无增加并发症。

背景:经皮内镜胃造口术(PEG)经常用于危重患者的非口服肠内营养(EN)。尽管有证据表明EN中断会导致更糟糕的结果，但基于管道的补充开始常常因各种原因而延迟。目的:确定危重患者在PEG置放后早期开始EN是否安全且耐受性良好，以及早期开始EN是否会导致更多的EN目标完成天数。设计:对接受PEG和至少24小时EN的患者进行回顾性图表回顾。根据开始管饲的时间对患者进行分层:立即(< 1小时)，早期(1至4小时)和晚期(4至24小时)。结果:三组在人口统计学、合并症和30天死亡率方面相似。立即治疗组61%的患者达到了先前达到的目标EN率，而早期和延迟治疗组分别为24%和18% (P < 0.0001)。结论:在PEG手术后立即重新开始非口服EN是安全的，并且与更快达到营养目标有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Connecticut Medicine Medicine-Medicine (all)

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期刊介绍： The Connecticut State Medical Society (CSMS) is a federation of eight component county medical associations, with a total membership exceeding 7,000 physicians. CSMS itself is a constituent state entity of the American Medical Association. Founded by the physician-patriots of the American Revolution, the Society operates from a heritage of democratic principles embodied in its Charter and Bylaws. The base of all authority in CSMS is, of course, the individual physician member. It is the decisions of members in their own county associations that ultimately determine the nature of the Society"s policies and activities.

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