Feasibility of International Proposed Standardized Enteral Connector for Semi-Solid Formula Feeding

2018 ◽  
Vol 73 (3) ◽  
pp. 169-176
Author(s):  
Michio Maruyama ◽  
Shohei Iijima ◽  
Nobuya Ishibashi ◽  
Michio Inukai ◽  
Tetsuharu Oriishi ◽  
...  

Background/Aims: The current study was undertaken to assess if the semi-solid formulas could be used with a new ENFit connector with similar force to current percutaneous endoscopic gastrostomy (PEG) tubes. Methods: Experiment 1: We measured the applied pressure (force) needed to compress the syringe containing 7 viscous semi-solid formulas with a 20 Fr PEG tube and low-profile tube through the ENFit connector or the current connector. Experiment 2: This experiment was conducted to evaluate the compression force through 2 connectors in 3 infusion velocity, 7 PEG tube types with 2 semi-solid formulas. Results: Experiment 1: The force needed to compress the syringe through the ENFit connector was higher in 3 semi-solid formulas with a 20 Fr low-profile tube; otherwise, there were no significant differences. Experiment 2: Each formula required a higher force in the ENFit connector in 6 settings out of 21. Conclusions: The ENFit connector will likely not show any remarkable change in the force to administer the semi-solid formula. However, a higher force was required under some conditions in the prototype ENFit connector. Further investigation of sensory test is needed to confirm the feasibility of the ENFit connector for using the semi-solid formulas.

Author(s):  
Yusaku Kajihara

Background: Even if preoperative enteral nutrition is administered without any issues, some patients suffer from gastrointestinal symptoms (e.g., vomiting and diarrhea) after initiating gastrostomy feeding. Because of the amino acid composition and limited amount of lipids, elemental diets may reduce the risk of gastrointestinal symptoms. However, elemental diets are expensive. Semi-solid medical foods are inexpensive and more closely mimic normal physiology than elemental diets. The aim of the present study was to investigate the usefulness of semi-solid medical foods when administered after percutaneous endoscopic gastrostomy (PEG).Method: This retrospective study analyzed 91 patients who had PEG performed by the author who was the attending physician. All patients received preoperative enteral nutrition with liquid nutrients, and there were no instances of gastrointestinal symptoms before PEG tube placement. The types of nutrients administered after PEG were divided into three categories: semi-solid medical foods (n = 20), polymeric formulas (n = 26), and elemental diets (n = 45). The incidence of gastrointestinal symptoms was compared among the three groups.Results: No gastrointestinal symptoms occurred in the semi-solid medical foods group; the incidence of gastrointestinal symptoms in the semi-solid medical foods group was significantly lower than that of the polymeric formulas group [0% vs. 26.9% (7/26), p 0.05] and was similar to that of the elemental diets group [0% vs. 2.2% (1/45), p = 1].Conclusion: If preoperative enteral nutrition is administered without any issues, semi-solid medical foods are useful as nutrients administered after PEG tube placement.


2020 ◽  
Vol 78 (1) ◽  
pp. 36-40
Author(s):  
Vanessa Huffman ◽  
Diana C Andrade ◽  
Elizabeth Sherman ◽  
Jianli Niu ◽  
Paula A Eckardt

Abstract Purpose Ledipasvir/sofosbuvir is an oral combination therapy containing fixed doses of direct-acting antiviral agents indicated for the treatment of hepatitis C virus (HCV) infection. Currently there are limited data on the clinical efficacy of crushed ledipasvir/sofosbuvir administered via feeding tube. Summary This case report discusses the successful treatment of chronic HCV genotype 1b infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy (PEG) tube in a patient with human immunodeficiency virus (HIV) coinfection and high-grade sarcoma who had severe swallowing difficulties. The patient received crushed ledipasvir/sofosbuvir daily for a total of 12 weeks. At 12 weeks the patient had achieved a sustained virologic response. Conclusion Currently, ledipasvir/sofosbuvir is available only as a tablet, with limited pharmacokinetic data available to guide clinicians on use of the fixed-dose combination medication in crushed form. This case report highlights our experience treating a patient with HCV/HIV coinfection through administration of crushed ledipasvir/sofosbuvir via PEG tube, which we found to be a safe and effective therapeutic option.


2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Christopher Nonso Ekwunife ◽  
Kelechi E. Okonta ◽  
Stephen E. Enendu

Objectives: Percutaneous endoscopic gastrostomy (PEG) is a well-established endoscopic procedure that is used predominantly to create enteral access for feeding. Its use has not been widespread in Nigeria despite its efficacy. This study is done to review the early experiences in the use of PEG in Federal Medical Centre, Owerri and Carez Clinic, Owerri. Material and Methods: This is a 4-year retrospective cross-sectional study of patients who had PEG from January 2015 to December 2018. The indications, complications, and outcomes of the procedure were analyzed. Results: A total of 13 patients had pull-type gastrostomy during this period. Six (46.1%) patients had the procedure on account of neurologic disorders, 4 (30.8%) patients had esophageal tumors, while 3 (23.1%) patients had esophageal motility disorders. The overall success rate for PEG tube placement was 100%. The most common complication was superficial skin infection 30.8% (4/13). No mortality was attributable to the procedure. Conclusion: PEG is still not commonly done in our setting, but it is a relatively safe procedure. Physicians should be encouraged to offer it to our teeming patients with neurologic disorders who may benefit from it.


Endoscopy ◽  
2019 ◽  
Vol 51 (07) ◽  
pp. 689-693 ◽  
Author(s):  
Pieter Hindryckx ◽  
Barbara Dhooghe ◽  
Andreas Wannhoff

Abstract Background Buried bumper syndrome (BBS) is a complication of percutaneous endoscopic gastrostomy (PEG) in which the internal bumper is overgrown by the gastric mucosa. Apart from loss of patency of the PEG tube, the buried bumper may evoke symptoms such as abdominal pain or peritubular leakage. While the management of an incompletely buried bumper is fairly straightforward, this is not the case for a completely buried bumper. Different approaches to remove completely buried bumpers have been described, including endoscopic knife- or papillotome-based techniques. However, these devices are used off-label and the procedures can be laborious. Methods The Flamingo device has recently been introduced as the first tool specifically designed to remove a completely buried bumper. Results We describe the technique and our first experience in five patients with a completely (n = 4) or almost completely (n = 1) buried bumper. Fast and save removal of the buried bumper was obtained in all patients. Conclusion We believe that this device has the potential to become the standard first-line tool for the management of completely buried bumpers.


2011 ◽  
Vol 140 (5) ◽  
pp. S-870
Author(s):  
Hiroaki Kusunoki ◽  
Ken Haruma ◽  
Naohito Yamashita ◽  
Keisuke Honda ◽  
Kazuhiko Inoue ◽  
...  

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