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Volume : 25 Issue : 4 Year : 2019

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Experiences of Percutaneous Endoscopic Gastrostomy in Our Neurology Intensive Care Unit Patients [Turk J Neurol]
Turk J Neurol. Ahead of Print: TJN-06745

Experiences of Percutaneous Endoscopic Gastrostomy in Our Neurology Intensive Care Unit Patients

Levent Öcek1, Özge Öcek2, Nurullah Damburacı3
1Department of Neurology, Uşak University Medical School, Uşak, Turkey
2Department of Neurology, Uşak Training and Research Hospital, Uşak, Turkey
3Department of General Surgery, Uşak University Medical School, Uşak,Turkey

Objective: Nutritional support has significant clinical importance in patients with poor or no oral intake admitted to neurology intensive care unit. Requirement for, administration methods, and benefits of active enteral feeding with feeding tubes remain a matter of dispute, particularly with respect to patients with impaired swallowing function following central nervous system involvement. In this study, we evaluated the patient characteristics and Percutaneous endoscopic gastrostomy (PEG)-related problems in a group of neurological intensive care unit patients.
Materials and Methods: Patients undergoing PEG and admitted to our neurological intensive care unit (NICU) between May 2016 and March 2018 were retrospectively examined. Age, gender, duration of intensive care stay, need for mechanical ventilation, occurrence of pneumonia, and PEG-related complications were recorded.
Results: A total of 789 patients admitted to NICU were screened. PEG use was identified among 41 (5.2%) of these patients, of whom 23 (56.1%) were female and 18 (43.9%) were male, with a mean age of 73.66 ±17.67 years(range: 32-94 y). Twenty-nine(70.7%) of these patients with PEG use were diagnosed with an ischemic etiology, while 7(17.1%) were diagnosed with hemorrhagic cerebrovascular disease. The mean duration of intensive care was 48.8 ± 30.6(13-150) das. On average, PEG was applied 29.12 ±7.97 days (13-42) after admission. Twelve patients (29.3%) were receiving mechanical ventilation, while 8(19.5%) required a tracheostomy due to prolonged mechanical ventilator support. Prior to PEG, 25 patients(61.4%) had a diagnosis of pneumonia, while 15 patients(36.6%) were diagnosed with pneumonia after PEG. PEG-associated nutritional intolerance developed in 5 patients (12.2%).
Conclusion: In agreement with published literature, PEG-related complications were low in frequency and there were no cases of PEG-related mortality. In neurological conditions associated with chronic and severe sequela requiring long-term nutritional support, PEG may be preferred on the basis of its ability to provide safe and physiological nutrition, ease of use, and low rate of complications.

Keywords: Neurology Intensive Care Unit, Percutaneous endoscopic gastrostomy, Enteral Nutrition.




Corresponding Author: Levent Öcek, Türkiye


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