Clin Endosc.  2020 Nov;53(6):705-716. 10.5946/ce.2019.196.

Clinical Outcomes of Percutaneous Endoscopic Gastrostomy in the Surgical Intensive Care Unit

• Pih GY
• Na HK
• Hong SK
• Ahn JY
• Lee JH
• Jung KW
• Kim DH
• Choi KD
• Song HJ
• Lee GH
• Jung HY

• KMID: 2511230
• DOI: http://doi.org/10.5946/ce.2019.196

Abstract

Background/Aims
Percutaneous endoscopic gastrostomy (PEG) is usually performed on patients with chronic underlying diseases in the general ward (GW). This study evaluated the clinical outcomes of PEG performed on patients in the surgical intensive care unit (SICU) compared with those of PEG performed in the GW.
Methods
The medical records of 27 patients in the SICU and 263 in the GW, who underwent PEG between January 2013 and July 2017, were retrospectively reviewed.
Results
The median age of the 27 SICU patients was 66 years, and their median body mass index was 21.1 kg/m². In the SICU group, the median baseline Sequential Organ Failure Assessment (SOFA) score was 4, and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 16. The median interval between surgery and PEG in SICU patients was 30 days, with a PEG failure rate of 3.7%. Acute complications in SICU patients included bleeding (7.4%) and ileus (11.1%), while chronic complications included aspiration pneumonia (7.4%) and tube obstruction (3.7%). The rates of acute and chronic complications did not differ significantly between the SICU and GW groups. The 30-day mortality rate was 14.8% in SICU patients and 5.3% in GW patients (p=0.073).
Conclusions
PEG is a safe and feasible method of enteral feeding for critically ill patients who require ICU care after surgery.

Keyword

Endoscopy; Gastrostomy; Intensive care unit

Figure

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  Fig. 1. Study flowchart. ER, emergency room; MICU, medical intensive care unit; PEG, percutaneous endoscopic gastrostomy; SICU, surgical intensive care unit.

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  Fig. 2. Percutaneous endoscopic gastrostomy (PEG) insertion in a surgical intensive care unit patient with a surgical wound in the abdomen. (A) Insertion of a double-lumen gastropexy needle in the stomach. (B) Penetration of the gastric wall using a trocar and a peel-away sheath. (C) Fixation by inflation of the balloon with saline. (D) Placement of the PEG tube into the patient’s abdomen.

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