scholarly journals Attitude and experience of neurologists towards percutaneous endoscopic gastrostomy: an Egyptian study

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Sherien Farag ◽  
Shady S. Georgy ◽  
Mai Fathy ◽  
Ahmed elSadek ◽  
Khaled O. Abdulghani
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Neurological Diseases ◽  
Public Awareness ◽  
Cerebrovascular Disorders ◽  
Common Symptom ◽  
Nasogastric Feeding ◽  
Endoscopic Gastrostomy ◽  
Intervention Failure ◽  
Self Administered Questionnaire ◽  
Nasogastric Tube Insertion

Abstract Background Dysphagia is a common symptom among various neurological diseases. Guidelines recommend gastrostomy insertion for prolonged dysphagia with lower rate of intervention failure encountered with percutaneous endoscopic gastrostomy (PEG) as compared to nasogastric tube insertion. Methods Neurology consultants only were included and completed a self-administered questionnaire concerning their practice backgrounds and previous experience with PEG feeding during their practice. Results Ninety-eight percent stated that they would recommend PEG for patients with prolonged need of nasogastric feeding. However, only 88% actually referred patients to perform PEG, with the cerebrovascular disorders being the most common cases to be referred. The main barriers the surveyed neurologists faced were family resistance and financial reasons (53.5%). Interestingly, younger neurologists practicing for less than 15 years referred patient to perform PEG significantly more frequent than older ones (p = 0.01). About 18% of our sample confirmed the lack of sufficient knowledge about the benefits of PEG feeding, and only 22% previously attended scientific sessions about the benefits and indications of PEG. Conclusion Based on our study, we recommend that PEG should be more encouraged in indicated neurological cases. Scientific sessions targeting neurologists and public awareness about the benefits of PEG and its relatively infrequent complications are highly demanded.

Perceptions of caregivers following percutaneous endoscopic gastrostomy in children with congenitally malformed hearts

2009 ◽  
Vol 19 (5) ◽  
pp. 507-510 ◽  
Author(s):  
Ramesh Srinivasan ◽  
Catherine O’Neill ◽  
Wendy Blumenow ◽  
A. Mark Dalzell
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Nutritional Support ◽  
Parental Perceptions ◽  
Nasogastric Feeding ◽  
Endoscopic Gastrostomy ◽  
Qualitative Survey ◽  
Gastrostomy In Children ◽  
Structured Questionnaire ◽  
Descriptive Qualitative

AbstractIntroductionWhile the usefulness of percutaneous endoscopic gastrostomy is clearly established in the nutritional support of children with neurodisability, the role in substituting for prolonged nasogastric feeding in children with congenitally malformed hearts is a relatively recent development. There are no previously published experiences of the perceptions of parents or those providing care following the insertion of percutaneous endoscopic gastrostomy in such children.MethodsDescriptive qualitative survey of parental perceptions using a semi-structured questionnaire.ResultsWe obtained completed 27 point semi-structured questionnaires from 38 providers of care for children with congenitally malformed hearts. Time taken to feed their children reduced significantly after the percutaneous endoscopic gastrostomy, from 30 to 60 minutes previously to 15 minutes subsequently. The frequency of feeding also reduced significantly, from 6 times a day to 4 to 5 times a day. Those providing care perceived significant reductions in pre-procedural symptoms, the ease of administering medications, and noted an enhanced level of happiness in their children. Of those providing care, 97% were highly satisfied with the procedure, with 15 parents (40%) wishing that the operation was done earlier, while the remainder considered it had been done at the appropriate time.ConclusionsThose caring for children with congenitally malformed hearts perceive significant improvements in the symptoms, wellbeing, and ease of administering medication for their children after percutaneous endoscopic gastrostomy. Of the group, 97% regarded the procedure as the appropriate means of assisting nutritional support.

Percutaneous Endoscopic Gastrostomy for Elderly Patients; A Comparative Study with Nasogastric Feeding

1991 ◽  
Vol 3 (2) ◽  
pp. 206-213 ◽  
Author(s):  
Tamaki YAMADA ◽  
Hayato OHNISHI ◽  
Tohru MATSUURA ◽  
Satoru ADACHI ◽  
Toshiyuki YAMAMOTO ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Comparative Study ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Nasogastric Feeding ◽  
Endoscopic Gastrostomy

Endoscopic Techniques for Obtaining Enteral Access

2017 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

Abstract WP181: Timing of Percutaneous Endoscopic Gastrostomy (PEG) for Acute Ischemic Stroke Inpatients in the United States

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
George P Albert ◽  
Benjamin P George ◽  
Adam G Kelly ◽  
David Y Hwang ◽  
Robert G Holloway
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Oldest Old ◽  
Age Groups ◽  
The United States ◽  
Nasogastric Feeding ◽  
Adult Age ◽  
Endoscopic Gastrostomy ◽  
To Receive

Background and Purpose: Stroke guidelines recommend time-limited trials of nasogastric feeding prior to placement of percutaneous endoscopic gastrostomy (PEG) tubes. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke. Methods: We designed a retrospective observational study to examine time to PEG for ischemic stroke admissions in the Nationwide Inpatient Sample, 2001-2011. We defined early PEG placement as 1-7 days from admission. Using multivariable regression analysis, we identified the effects of patient and hospital characteristics on time to PEG. Results: We identified 34,623 admissions receiving a PEG from 2001-2011, 53% of which received the PEG early. Among hospitals placing ≥10 PEG tubes, median time to PEG for individual hospitals ranged from 3 days to over 3 weeks (interquartile range: 6-8.5 days). Older adult age groups were associated with early PEG placement (≥85 years vs. 18-54 years: Adjusted Odds Ratio [AOR] 1.68, 95% CI 1.50-1.87). Those receiving a PEG tube and tracheostomy were less likely to receive the PEG early (vs. no tracheostomy; AOR 0.27, 95% CI 0.24-0.29), and these patients were more often younger compared to PEG only recipients ( Figure ). Those admitted to high volume hospitals were more likely to receive their PEG early (≥350 vs. <150 hospitalizations; AOR 1.26, 95% CI 1.17-1.35). Conclusions: More than half of PEG recipients received their surgical feeding tube within 7 days of admission. The oldest old, who may be the most likely to benefit from time-limited trials of nasogastric feeding, were most likely to receive a PEG early.

scholarly journals Use of Ibrutinib Via Nasogastric (NG) Tube & Percutaneous Endoscopic Gastrostomy (PEG) Tube

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5371-5371 ◽  
Author(s):  
Jamie M Maddox ◽  
Mohammed Majid
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Nasogastric Tube ◽  
Chop Chemotherapy ◽  
Capsule Formulation ◽  
Nasogastric Feeding ◽  
Disease Response ◽  
Ramsay Hunt Syndrome ◽  
Endoscopic Gastrostomy ◽  
Hunt Syndrome ◽  
Peg Tube

Abstract We describe the successful administration of ibrutinib via nasogastic (NG) tube & percutaneous endoscopic gastrostomy (PEG)tube. It was not previously known by the manufacturer if this route of administration was possible. Our patient was a 71 year old man diagnosed with a leukaemic variant mantle cell lymphoma. He was commenced on R-CHOP (rituximab, cyclophospahmide, doxorubicin, vincristine, prednisolone) chemotherapy however after 3 cycles of chemotherapy there was no reduction in his lymphadenopathy or splenomegaly despite a reduction in the peripheral blood lymphocytosis. During the R-CHOP chemotherapy, the patient suffered left-sided facial shingles causing Ramsay Hunt syndrome. He was left with a residual neurological swallowing deficit requiring nasogastric feeding. Due to the lack of response to R-CHOP chemotherapy, we felt that ibrutinib could be a useful second line treatment, however we were not sure if the capsule could be opened to allow administration via his nasogastric tube. We contacted the manufacturer who said that there was no data about this method of administration and therefore it was not recommended. Our own research identified one ongoing clinical trial comparing suspension and sprinkle formulations of ibrutinib to the capsule formulation (NCT02390609). This trial was unreported however we felt encouraged that this method of administration did seem feasible. It was felt that ibrutinib represented the best chance of a useful disease response so full dose treatment was commenced via the nasogastric tube. This was later changed to a percutaneous endoscopic gastrostomy (PEG) tube. The patient opened the capsule and flushed the contents down the tube with water. A follow up blood count 2 weeks later showed a marked lymphocytosis (baseline lymphocyte count 0.4 x109/L, risen to 40.8 x 109/L), as would be expected with ibrutinib therapy. This reduced to near normal values over the following 3 months, accompanied by an improvement in the haemoglobin and platelet counts. Imaging at 3 months confirmed compete resolution of all pre-existing lymphadenopathy and the previous 25.6 cm splenomegaly. Our patients' dramatic response suggests that capsule formulation ibrutinib can be successfully administered by NG or PEG tubes. Disclosures Maddox: Janssen: Other: Funding to attend ASH 2016 (travel, accommodation, registration); Boehringer-Ingelheim: Other: Funding to attend ASH 2014 (travel, accommodation, registration).

An evaluation of percutaneous endoscopic gastrostomy feeding in AIDS

1996 ◽  
Vol 7 (2) ◽  
pp. 106-109 ◽  
Author(s):  
S Dowling ◽  
D Kane ◽  
A Chua ◽  
S Keating ◽  
P Flood ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Drug Users ◽  
Intravenous Drug Users ◽  
Lower Serum ◽  
Endoscopic Gastrostomy ◽  
Progressive Weight Loss ◽  
Gag Reflex ◽  
Peg Tube ◽  
Self Administered Questionnaire ◽  
Oesophageal Candidiasis

Between October 1991 and October 1993, 17 AIDS patients (14 intravenous drug users, 3 sexually acquired) were com menced on percutaneous endoscopic gastrostomy (PEG) feeding in St James's Hospital. Indications were progressive weight loss related to severe anorexia (11), persistent oesophageal candidiasis (5) and absence of gag reflex (1). Two patients requested PEG tube rem oval after one week because of cram py abdom inal pain without peritonitis. Five patients died from AIDS related infections within 6 weeks of PEG insertion. Ten patients were followed up for > 2 months (mean 5.2 months, range 2.5-15.5 months). In these 10 patients, 1 patient developed a PEG site infection which responded to topical antibiotics. There were no other complications. There was a significant ( P < 0.001) increase in energy and protein intake at 2 months. Variant degrees of weight gain occurred in all patients (mean 2.6 kg) (P < 0.01). Small but significant increases in other anthropometric variables occurred. Patients who died within 6 weeks of PEG insertion were older, and had a lower serum album in than the group who survived > 2 months (P < 0.01). A self-administered questionnaire demonstrated that the majority of patients found PEG feeding acceptable and preferable to nasogastric (NG) feeding.

Percutaneous endoscopic gastrostomy in neurological diseases

1998 ◽  
Vol 114 ◽  
pp. A881
Author(s):  
C Guédon ◽  
P Hochain ◽  
A Zalar ◽  
P Ducrotté
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Neurological Diseases ◽  
Endoscopic Gastrostomy

P245 PERCUTANEOUS ENDOSCOPIC GASTROSTOMY IN NEUROLOGICAL DISEASES

2009 ◽  
Vol 4 (2) ◽  
pp. 128 ◽  
Author(s):  
P. Kohout ◽  
Z. Antos ◽  
G. Puskarova ◽  
M. Rozmahel ◽  
M. Cernik ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Neurological Diseases ◽  
Endoscopic Gastrostomy

Endoscopic Techniques for Obtaining Enteral Access

2017 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

Endoscopic Techniques for Obtaining Enteral Access

2018 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

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