Randomized Prospective Trial of Early Versus Delayed Feeding After Percutaneous Endoscopic Gastrostomy Placement

McCarter, Timothy L.; Condon, Stanley C.; Aguilar, R; Gibson, Dorothy J.; Chen, Yang

doi:10.1111/j.1572-0241.1998.00419.x

Cited by 81 publications

(18 citation statements)

References 10 publications

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“…It was expected that, during that time, the GI system returns to normal function and better seal of the enteral opening is achieved (138 -140). Later, several prospective randomized studies (141)(142)(143)(144)(145) clearly demonstrated that earlier initiation of feeding at 3 hours (141,142), 4 hours (143), and even immediately (144) is safe. These data were further analyzed and confirmed in metaanalysis by Bechtold et al (145) that summarized six randomized trials.…”

Section: Initiation Of Feedingmentioning

confidence: 99%

Multidisciplinary Practical Guidelines for Gastrointestinal Access for Enteral Nutrition and Decompression From the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, With Endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE)

et al. 2011

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Section: Initiation Of Feedingmentioning

confidence: 99%

Multidisciplinary Practical Guidelines for Gastrointestinal Access for Enteral Nutrition and Decompression From the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, With Endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE)

et al. 2011

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“…L'utilisation pr6coce de la sonde clans les 3 ~ 6 heures peut se faire sans risque, en perfusant en premier lieu du sdrum sal6 st6rile pour ddtecter une fuite p6ri-ton6ale [20,21].…”

Section: Apr~s La Poseunclassified

Gastrostomie percutanée endoscopique

Sidaner

2002

Acta Endosc

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Percutaneous endoscopic gastrostomy RESUME La gastrostomie percutan6e endoscopique est actuellement la voie d'abord de r6fdrence pour l'alimentation ent6rale prolong6e. La simplicit6 et la rapidit6 de la technique, l'6volution du matdriel font que les gastro-entdrologues sont de plus en plus sollicitds et que la pose est accessible ~ tout endoscopiste. Le respect des contre-indications et la rigueur dans la rdalisation de la procddure sont la c16 de la r6ussite du geste endoscopique, d'un faible taux de morbidit6 et de mortalit6. SUMMARY Percutaneous endoscopic gastrostomy is now the most appropriate method for long-term enteral feeding. Because of the simplicity and rapidity of this procedure, and technical improvements, gastroenterologists are increasing by asked to perform PEG placement. This technique can be performed by any endoscopist.Observance of the contraindications, and strict adherence to the procedure are the keys for a successful endoscopic outcome with low morbidity and mortality. INTROD UCTIONDepuis sa description princeps en 1980 par Gauderer et Ponsky, la gastrostomie percutande endoscopique (GPE) a connu un essor dans le domaine de la nutrition ent6rale de longue dur6e (> 4 semaines). Les r6sultats de l'enqu6te SFED 2002 [1] montrent que la GPE est le premier geste th6rapeutique r6alis6 lors de l'endoscopie ceso-gastro-duod6nale (tableau I). Plus de 1 000 publications sur la gastrostomie percutan6e sont parues depuis 1980, 279,000 GPE ont 6t6 pos6es aux USA, il existe 13 fabricants de mat6riel (USA), soit plus de 260 000 kits produits chaque ann6e [2]. La diffusion et la simplicit6 de la technique font que ses indications se sont progressivement 61argies, posant parfois des problbmes d'ordre 6thique. INDICATIONS ET CONTRE-INDICA TIONS [3] IndicationsElles correspondent a celles de la nutrition ent6rale de longue dur6e d6finie par une durde sup6rieure un mois, si l'esp6rance de vie du patient est suffisante. Les principales indications sont les troubles de d6glu-tition avec fausses routes et pneumopathies d'inhalation, les dysphagies, les d6nutritions par insuffisance Chez l' enfant :--s6quelles d'anoxie c6r6brale ; --affections neuro-musculaires cong6nitales ; --enc6phalopathies, mucoviscidose. Plus rarement utilis6e pour d6compression gastrointestinale darts les pseudo-obstructions ou les st6noses intestinales, carcinoses p6riton6ales [4].De nombreuses 6tudes se sont int6ress6es au suivi des malades apr~s la pose d'une GPE mais n'ont pas permis de d6gager des facteurs pronostiques. Une hypoalbumin6mie inf6rieure ~ 30 g/1 serait pr6dictive d'une mortalit6 61ev6e ~ court terme [5]. Au cours de la scl6rose lat6rale amyotrophique (SLA), une prise en charge nutritionnelle pr6coce (5 % de perte de poids) augmente le taux de survie ~ 2 ans (40 % vs 5 %) [6]. Chez le sujet ~g6, la pr6sence d'une infection pulmonaire et d'escarres au moment de la pose de la GPE sont des facteurs de mauvais pronostic court et long termes [7]. II semble donc essentiel que la pose de la GPE ne soit pas trop tardive dans ...

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“…The first choice for surgical patients who will not be submitted to laparotomy is percutaneous endoscopic gastrostomy (PEG). This fast, easy procedure can be done with local anesthesia at the bedside; it has low morbidity rates and permits early initiation of enteral feeding [28]. Relative contraindications include previous upper abdominal surgery, obesity, and bleeding disorders.…”

Section: Gastrostomymentioning

confidence: 99%

Access Routes for Nutritional Therapy

Waitzberg¹,

Plopper²,

Terra³

2000

World j. surg.

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Enteral nutrition (EN) and total parenteral nutrition (TPN) may provide life-sustaining therapy for surgical patients. The duration of nutritional therapy (enteral or parenteral) implies distinct access routes. We review the main aspects related to access routes for nutrient delivery. The enteral route, whenever feasible, is preferred. For EN lasting less than 6 weeks, nasoenteric tubes are the route of choice. Conversely, enterostomy tubes should be used for longer-term enteral feeding and can be placed surgically or with fluoroscopic and endoscopic assistance. The first choice for patients who will not be submitted to laparotomy is percutaneous endoscopic gastrostomy. Postpyloric access, although not consensual, must be considered when there is a high risk of aspiration. For intravenous delivery of nutrients lasting less than 10 days, the peripheral route can be used. However, because of frequent infusion phlebitis, its role is still in discussion. Central venous catheters (CVCs) for TPN delivery may be (1) nonimplantable, percutaneous, nontunneled-used for a few days to 3 to 4 weeks; (2) partially implantable, percutaneous, tunneled-used for longer periods and permanent access; or (3) totally implantable subcutaneous ports-also used for long-term or permanent access. The subclavian vein is usually the insertion site of choice for central venous catheters. Implantable ports are associated with lower rates of septic complications than percutaneous CVCs. The catheter with the least number of necessary lumens should be applied. Central venous nutrient delivery can also be accomplished through peripherally inserted central catheters, which avoid insertion-related risks.

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Randomized Prospective Trial of Early Versus Delayed Feeding After Percutaneous Endoscopic Gastrostomy Placement

Abstract: Early initiation of PEG feedings is safe, well tolerated, and reduces cost by decreasing hospital stay.

Cited by 81 publications

References 10 publications

Gastrostomie percutanée endoscopique

Access Routes for Nutritional Therapy

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