Enteral Feeding Within Three Hours After Percutaneous Endoscopic Gastrostomy Placement

Szary, Nicholas M.; Arif, Murtaza; Matteson, Michelle; Choudhary, Abhishek; Puli, Srinivas R.; Bechtold, Matthew L.

doi:10.1097/mcg.0b013e3181eeb732

Cited by 43 publications

(41 citation statements)

References 14 publications

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“…A meta‐analysis of 5 randomized controlled trials compared early feeding after PEG placement (≤3 hours) with delayed or next‐day feeding and found no significant differences in complications, deaths in the first 72 hours, or number of significant gastric residual volumes at day 1 84 . A retrospective study examined the safety and outcomes of early feedings (≤4 hours) during a 5‐year period at a tertiary care center where the majority of PEG procedures were performed on inpatients by gastroenterologists 85 .…”

Section: Section 4 Enteral Accessmentioning

confidence: 99%

“…The tract begins to mature approximately 7–10 days after PEG placement, and it takes a few weeks for fusion to take place between the stomach and peritoneum. In malnourished or immunocompromised patients, this process can take longer 84 . Patients who are discharged home with a newly inserted PEG tube must be closely monitored to prevent inadvertent dislodgement.…”

Section: Section 4 Enteral Accessmentioning

confidence: 99%

See 1 more Smart Citation

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

349

531

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Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process-related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.

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Section: Section 4 Enteral Accessmentioning

confidence: 99%

Section: Section 4 Enteral Accessmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

349

531

View full text Add to dashboard Cite

show abstract

“…Another proposed rationale for delayed feeding is to allow time for better sealing of the gastrostomy tract around the gastrostomy tube, thus reducing the chance of leakage of gastric contents and peritonitis (14). However, the practice of delayed feeding has been questioned in the PEG literature and multiple studies have demonstrated that early feeding, typically < 3 hours but even as soon as 1 hour after PEG, is safe (5-10). Endoscopists have argued that delayed feeding offers little benefit because bowel sounds, audible fairly soon if not immediately after PEG placement, indicate normal function (7).…”

Section: Discussionmentioning

confidence: 99%

“…The overall success and complication rates are comparable between the two percutaneous techniques and both are used routinely in oncology patients (3-4). While several studies have shown that feeding can safely be initiated in select patients < 3 hours following PEG tube placement (5-10), at many centers, patients are admitted to the hospital for observation and are not fed for 12 to 24 hours following PFG placement (11-13). This study was done to evaluate the feasibility and safety of early feeding following outpatient PFG placement in oncology patients.…”

Section: Introductionmentioning

confidence: 99%

Early Initiation of Enteral Feeding in Cancer Patients after Outpatient Percutaneous Fluoroscopy-Guided Gastrostomy Catheter Placement

Sabir

Armstrong

Elting

et al. 2014

Journal of Vascular and Interventional Radiology

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Purpose To report the results of early enteral feeding in oncology patients following outpatient percutaneous fluoroscopic-guided gastrostomy (PFG) placement. Materials and Methods From January 2008 through December 2008, 121 consecutive outpatient oncology patients underwent PFG placement for nutrition. 113 patients met criteria and were fed early (after at least 3 hours). Of these patients, 5 had insufficient follow up for further analysis leaving 108 patients for outcomes analysis. After PFG placement, patients were put on low-wall suction via the PFG for one hour followed by feeding via PFG at least three hours after placement. Follow-up was obtained on the next business day. The medical records were reviewed for the outcomes of early feeding, technical aspects of the procedures, and complications. Results Following PFG placement, 93% (113/121) of patients met criteria for early feeding and 91% (103/113) of these patients were fed within 5 hours of PFG insertion. The median time between the end of procedure and initiation of feeding was 4 hours (range 3-6.5 hours). The 30-day minor complication rate was 14% (15/108) and major complication rate was 0.9% (1/108). No complications were directly attributable to early feeding. Conclusion Early initiation of tube feedings following outpatient PFG placement was well tolerated in oncology patients and carried no additional risk compared with previously reported results using traditional delayed feeding protocols. Early feeding provided our patients with prompt enteral nutrition and eliminated the need for post-procedural hospital admission.

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“…Therefore, monitoring gastric residual volumes is no longer recommended in critically ill medical patients. Furthermore, a study by Szary et al 54 found that feeding ≤3 hours after PEG placement showed gastric residual volumes were not increased within the first 24 hours compared with delayed feedings. Feeding early after PEG placement does not appear to increase the risk of aspiration.…”

Section: Feeding After Tube Placementmentioning

confidence: 99%

Long‐Term Nutrition

et al. 2016

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Long-term nutrition support requires long-term enteral access. To ensure the success of long-term enteral access, many factors need to be taken into consideration. This article represents a guide to placing and maintaining access in patients requiring long-term nutrition and addresses many of the common questions regarding long-term enteral access, such as indications, types of access, feeding after access placed, and recognition and treatment of potential complications. This guide will help the clinician establish and maintain access to maximize nutrition in patients requiring long-term nutrition.

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Enteral Feeding Within Three Hours After Percutaneous Endoscopic Gastrostomy Placement

Abstract: Early tube feeding ≤3 hours after PEG placement has no significant differences to delayed or next-day feeding in respect to complications, death in ≤72 hours, or number of significant gastric residual volumes at day 1.

Cited by 43 publications

References 14 publications

ASPEN Safe Practices for Enteral Nutrition Therapy

ASPEN Safe Practices for Enteral Nutrition Therapy

Early Initiation of Enteral Feeding in Cancer Patients after Outpatient Percutaneous Fluoroscopy-Guided Gastrostomy Catheter Placement

Long‐Term Nutrition

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