scholarly journals Percutaneous endoscopic gastrostomy feeding in patients with cystic fibrosis

Gut ◽  
1999 ◽  
Vol 44 (1) ◽  
pp. 87-90 ◽  
Author(s):  
S G J Williams ◽  
F Ashworth ◽  
A McAlweenie ◽  
S Poole ◽  
M E Hodson ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Nutritional Status ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Tube Feeding ◽  
Late Complications ◽  
Albumin Concentration ◽  
Management Problem ◽  
Endoscopic Gastrostomy

BackgroundMalnutrition is a common management problem in patients with cystic fibrosis (CF). Various approaches to supplemental nutrition by both parenteral and enteral routes have been used.AimTo analyse the efficacy and acceptability of supplemental overnight feeding using a percutaneous endoscopic gastrostomy (PEG) in patients with CF.Patients53 patients with CF (43 adults; age >17 years) with severe pulmonary disease.MethodsThe technical success and complications of PEG insertion were documented together with changes in nutritional and pulmonary status of the cohort.ResultsPEG tubes were successfully inserted in all patients, with immediate complications (respiratory depression) in two (4%) and late complications in 13 (25%). Feeding was well tolerated by 50/51 (98%) of the cohort during a mean (SEM) follow up of 14.5 (2.1) months. The adult cohort had a significant increase in weight and body mass index at six months which was maintained at 12 months. Serum albumin concentration remained stable at six months but had fallen by 12 months, although the differences were not statistically significant. These results were reflected in the paediatric cohort. Pulmonary function in those followed up for one year had apparently stabilised, but the number of admissions to hospital over the year before and the year after PEG did not change. Half of the cohort were accepted for heart-lung/lung transplantation, the improvement in nutritional status being a prerequisite for this.ConclusionSupplemental PEG tube feeding is well tolerated and results in a significant improvement in nutritional status and an apparent stabilisation of pulmonary function in severely malnourished CF patients with advanced pulmonary disease.

scholarly journals May chronic cough in chronic obstructive pulmonary disease be a contraindication of Percutaneous Endoscopic Gastrostomy placement: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. G. Gravina ◽  
A. Tessitore ◽  
V. M. Ormando ◽  
F. Nagar ◽  
M. Romeo ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Chronic Cough ◽  
Gastric Wall ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Percutaneous Endoscopic Gastrostomy Placement ◽  
Endoscopic Gastrostomy ◽  
Track Record

Abstract Background Percutaneous Endoscopic Gastrostomy (PEG) can involve some complications, despite the good safety of its track record. The Buried Bumper Syndrome (BBS) is a rare, late and dangerous complication that consists in the erosion of the internal bumper through the gastric wall. Case presentation We report the development of BBS in a man with chronic obstructive pulmonary disease (COPD) who had a persistent chronic cough which was prevalently but not solely in the morning and required placement of a PEG tube for continuous infusion of Levodopa/carbidopa intestinal gel for advanced Parkinson's disease. Conclusion We believe that COPD with chronic cough while not representing an absolute contraindication to PEG placement, may potentially cause BBS and therefore an appropriate regimen of tube care by expert personnel is mandatory in this setting.

Diabetes Mellitus in Patients With Cystic Fibrosis: Effect on Survival

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 374-377
Author(s):  
J. Reisman ◽  
M. Corey ◽  
G. Canny ◽  
H. Levison
Keyword(s):  
Diabetes Mellitus ◽  
Cystic Fibrosis ◽  
Survival Analysis ◽  
Nutritional Status ◽  
Pulmonary Function ◽  
Survival Data ◽  
Diabetes Diagnosis ◽  
Patients With Diabetes ◽  
Insulin Dependent ◽  
Sick Children

Patient data obtained from the cystic fibrosis clinic of the Hospital for Sick Children (Toronto, Canada) over the period 1977 to 1988 were analyzed to compare the diabetic and nondiabetic cystic fibrosis patients. The pulmonary function, nutritional status, and survival data for 713 patients who attended the clinic over the 11-year period are reported. Insulin-dependent diabetes was found to exist in 37 (5.2%) of 713 patients. The patient age at time of diabetes diagnosis ranged from 2 to 34 years, with a mean ± SD of 20.0 ± 7.4 years. Patients who died in both the diabetic and nondiabetic groups had worse pulmonary and nutritional status than the surviving patients, but there were no significant differences between the diabetic and nondiabetic groups in those who died or in those who remained alive. Survival analysis showed a similar prognosis in the diabetic and nondiabetic groups. It is concluded that cystic fibrosis patients with diabetes are, for their age, not different from patients without diabetes with respect to pulmonary function, nutritional status, and survival.

scholarly journals General Paediatric Surgical Provision of Percutaneous Endoscopic Gastrostomy in a District General Hospital – A 12-Year Experience

2009 ◽  
Vol 91 (5) ◽  
pp. 404-409 ◽  
Author(s):  
T Sathesh-Kumar ◽  
Hazel Rollins ◽  
Sarah Cheslyn-Curtis
Keyword(s):  
General Hospital ◽  
Percutaneous Endoscopic Gastrostomy ◽  
District General Hospital ◽  
Late Complications ◽  
General Anaesthetic ◽  
Paediatric Surgery ◽  
Number Of Children ◽  
Endoscopic Gastrostomy ◽  
Local Access ◽  
The Uk

INTRODUCTION A small, but significant, number of children require long-term nutritional support. The aim of this study was to demonstrate the safety and efficacy of providing a percutaneous endoscopic gastrostomy (PEG) service for children in a district general hospital and to raise awareness of the suitability of the procedure to be performed on paediatric surgery lists in similar hospitals across the UK. PATIENTS AND METHODS A multidisciplinary paediatric nutrition team was established and all children accepted for PEG insertion between 1995 and 2007 were entered onto a database prospectively and are included in this study. PEG tubes were inserted by the standard pull-through technique under general anaesthetic. RESULTS A total of 172 procedures were performed in 76 children. The median age at first tube insertion was 3 years (range, 0.5–18 years). Length of follow-up ranged from 1 month to 12.6 years. Fifty-eight children (76%) had a neurological abnormality, the commonest being cerebral palsy. All but one procedure were performed successfully, of which 63 (37%) were new insertions, 99 change of tube, 4 changed from surgical gastrostomy and 6 from PEG to button gastrostomy. The median hospital stay was 2 days (range, 2–7 days) for new insertions and 1 day for tube changes. There were 10 (6%) early complications within 30 days, the commonest being peritubal infection (6). The 39 late complications included 16 peritubal infection/granulomata, 9 ‘buried bumpers’, 4 worsening of gastro-oesophageal reflux disease, 2 gastrocolic fistulae, 3 gastrocutaneous fistulae and 4 tubal migration. There was no mortality. CONCLUSIONS We have demonstrated that paediatric PEG procedures and continuing management by a supporting team can be successfully and efficiently provided in the district general hospital. It should be possible for the majority of similar hospitals to provide local access and increase the availability of PEG feeding for children.

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