scholarly journals Study of percutaneous endoscopic gastrostomy compared to nasogastric tube feeding in patients requiring prolong enteral nutritional support

2020 ◽  
Vol 7 (7) ◽  
pp. 2201
Author(s):  
Manik C. Gedam ◽  
Yogesh D. Mankar ◽  
Devdas S. Samala ◽  
Leena Y. Ingale ◽  
Lavanya L. ◽  
...  
Keyword(s):  
Aspiration Pneumonia ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Nutritional Support ◽  
Tube Feeding ◽  
Anthropometric Parameters ◽  
Skin Fold Thickness ◽  
Endoscopic Gastrostomy ◽  
Skin Fold ◽  
Triceps Skin Fold ◽  
Group 2

Background: The aims and objectives of this article were to compare the advantages, disadvantages associated with percutaneous endoscopic gastrostomy (PEG) and nasogastric (NG) tube and also to compare complications, to measure the outcomes in terms of hospital stay, mortality and improvement in nutritional status.Methods: In this prospective and interventional study 25 patients were selected in each group on an alternate basis. Study was conducted on cases of traumatic brain injury and cerebrovascular accident patients admitted in Department of General Surgery, IGGMC for a period of November 2013- November 2015 with a need to provide prolonged enteral nutritional support. Each patient was assessed by a dietician and received a standard enteral feeding according to their body weight. The main outcome was measures at 4 weeks were complications (tube dislodgement, aspiration pneumonia, tube blockade and peristomal infections) and nutritional status.Results: The anthropometric parameters (mid arm circumference, biceps skin fold thickness and triceps skin fold thickness) and serum albumin showed a rise in PEG group at 4 weeks when compared to baseline (0 week) whereas they showed a decline in NG group at follow up (4 weeks). The NG group has got higher mortality 4 (17%) when compared to PEG group 2 (7%) due to aspiration pneumonia. Hence, PEG is better tolerated with lesser complications better nutritional support as assessed by the anthropometric parameters at 4 weeks.Conclusions: We conclude that whenever feasible percutaneous endoscopic gastrostomy (PEG) feeding is a choice over nasogastric (NG) feeding in patients requiring long term enteral support.

scholarly journals Assessment of Serum Acylated Ghrelin in Children and Adolescents with Chronic Liver Diseases: Relation to Nutritional Status

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Z. A. Elkabbany ◽  
R. T. Hamza ◽  
N. H. Mahmoud
Keyword(s):  
Standard Deviation Score ◽  
Chronic Liver ◽  
Compensatory Mechanism ◽  
Acylated Ghrelin ◽  
Anthropometric Parameters ◽  
Laboratory Assessment ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Liver Functions ◽  
Triceps Skin Fold

Because ghrelin is one of the key hormones in regulating feeding behavior and caloric status, it was suggested that ghrelin behavior might be closely associated with malnutrition state of patients with chronic liver disease (CLD). Thus, we aimed to assess serum ghrelin levels in children with CLD and its relation to anthropometric parameters and severity of CLD. Forty CLD patients were studied in comparison to 40 controls. All subjects were subjected to history, anthropometric, and laboratory assessment of liver functions and serum acylated ghrelin. Ghrelin was higher in patients than controls being higher with progress of Child’s grade and with deterioration of liver functions. Hyperghrelinemia was detected in 62.5% of cases. Ghrelin correlated negatively with body mass index standard deviation score (BMISDS (r=-0.95,P<0.001)), triceps skin fold thickness (TSFT (r=-0.88,P<0.001)), and subscapular skin fold thickness (SSFT (r=0.83,P<0.001)) percentiles. In conclusion, hyperghrelinemia may represent a compensatory mechanism trying to overcome malnutrition state complicating CLD and can be used as a parameter for early detection and assessment of the severity of malnutrition in children with CLD.

Risk Factors for Aspiration Pneumonia after Percutaneous Endoscopic Gastrostomy

Gerontology ◽  
2007 ◽  
Vol 53 (4) ◽  
pp. 224-227 ◽  
Author(s):  
Toshiro Kitamura ◽  
Hajime Nakase ◽  
Hidehiko Iizuka
Keyword(s):  
Risk Factors ◽  
Aspiration Pneumonia ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Endoscopic Gastrostomy

Abdomen System

2010 ◽  
Author(s):  
Gautam Mehta ◽  
Bilal Iqbal
Keyword(s):  
Liver Disease ◽  
Vascular Lesions ◽  
Skin Fold Thickness ◽  
System P ◽  
Skin Fold ◽  
Normal Individuals ◽  
Palmar Erythema ◽  
Triceps Skin Fold ◽  
Specific Finding ◽  
Fat Stores

1. Jaundice is a marker of severity of liver disease, as well as a consequence of decompensation. Yellow discolouration is not usually seen until the serum bilirubin is >40μmol/L (twice the upper limit of normal), although the earliest signs of jaundice can be detected in the periphery of the conjunctivae, or in the buccal mucosa. Remember, there are other causes of jaundice in liver disease, such as Zieve’s syndrome (haemolysis and hyperlipidaemia in alcohol misuse), or biliary obstruction. 2. Cachexia can be established by demonstrating muscle and fat loss. Wasting of the temporalis muscle is an early sign of generalized muscle atrophy. A reduced triceps skin-fold thickness is a marker of loss of fat stores. This can be demonstrated by palpating for redundant skin over the triceps area between your thumb and forefingers. 3. Anaemia is most reliably demonstrated by looking for conjunctival pallor. This is thought to be more sensitive than looking for pallor of skin creases, nails, or other mucosal membranes. If there is no evidence of anaemia, it is an important negative to mention to the examiner. The principal causes of anaemia in chronic liver disease are blood loss from portal hypertensive gastropathy, alcohol excess causing bone marrow suppression and poor nutrition. 4. Other gastrointestinal (GI) causes of clubbing include inflammatory bowel disease (IBD), coeliac disease, GI lymphoma and rare causes of malabsorption such as tropical sprue and Whipple’s disease. 5. Leuconychia is a non-specific finding which is associated with hypoalbuminaemia as well as other conditions such as heart failure, renal disease, Hodgkin’s lymphoma (HL) and diabetes mellitus (see Case 8—Nephrotic Syndrome). 6. Palmar erythema reflects the vasodilated state of cirrhosis. Other causes of palmar erythema include hypercapnoea, rheumatoid arthritis, thyrotoxicosis, pregnancy, fever, and exercise. 7. Spider naevi are vascular lesions, with a central arteriole that supplies smaller surrounding vessels. Generally, the number and size correlate with the severity of liver disease, although they may occur in normal individuals and pregnancy. Spider naevi, palmar erythema, gynaecomastia, and loss of body hair are thought to be the consequence of altered sex hormone metabolism, and an increase in the oestradiol:free testosterone ratio.

scholarly journals Percutaneous Endoscopic Gastrostomy versus Nasogastric Tube Feeding: Oropharyngeal Dysphagia Increases Risk for Pneumonia Requiring Hospital Admission

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2969 ◽  
Author(s):  
Wei-Kuo Chang ◽  
Hsin-Hung Huang ◽  
Hsuan-Hwai Lin ◽  
Chen-Liang Tsai
Keyword(s):  
Hospital Admission ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Nasogastric Tube ◽  
Oropharyngeal Dysphagia ◽  
Tube Feeding ◽  
Pyriform Sinus ◽  
Control Group ◽  
Endoscopic Gastrostomy ◽  
Endoscopic Observation ◽  
Laryngeal Vestibule

Background: Aspiration pneumonia is the most common cause of death in patients with percutaneous endoscopic gastrostomy (PEG) and nasogastric tube (NGT) feeding. This study aimed to compare PEG versus NGT feeding regarding the risk of pneumonia, according to the severity of pooling secretions in the pharyngolaryngeal region. Methods: Patients were stratified by endoscopic observation of the pooling secretions in the pharyngolaryngeal region: control group (<25% pooling secretions filling the pyriform sinus), pharyngeal group (25–100% pooling secretions filling the pyriform sinus), and laryngeal group (pooling secretions entering the laryngeal vestibule). Demographic data, swallowing level scale score, and pneumonia requiring hospital admission were recorded. Results: Patients with NGT (n = 97) had a significantly higher incidence of pneumonia (episodes/person-years) than those patients with PEG (n = 130) in the pharyngeal group (3.6 ± 1.0 vs. 2.3 ± 2.1, P < 0.001) and the laryngeal group (3.8 ± 0.5 vs. 2.3 ± 2.2 vs, P < 0.001). The risk of pneumonia was significantly higher in patients with NGT than in patients with PEG (adjusted hazard ratio = 2.85, 95% CI: 1.46–4.98, P < 0.001). Cumulative proportion of pneumonia was significantly higher in patients with NGT than with PEG for patients when combining the two groups (pharyngeal + laryngeal groups) (P = 0.035). Conclusion: PEG is a better choice than NGT feeding due to the decrease in risk of pneumonia requiring hospital admission, particularly in patients with abnormal amounts of pooling secretions accumulation in the pyriform sinus or leak into the laryngeal vestibule.

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