Percutaneous Endoscopic Gastrostomy Tube Placement in COVID-19 Patients

Intensive care units (ICU) around the world are overburdened with COVID-19 patients with ventilator-dependent chronic respiratory failure (VDRF). Gastroenterology evaluations are being made to address the provision of chronic enteral feeding with the help of percutaneous endoscopic gastrostomy (PEG) placements in these patients. The placement of the PEG tube along with tracheostomy in patients with COVID-19 and prolonged VDRF may expedite discharge planning and increase the availability of ICU beds for other patients. Herein, we describe a multidisciplinary approach of PEG tube placements for patients with SARS-CoV-2-induced chronic VDRF for continued enteral feeding to avoid complications and decrease the length of stay.

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Meningitis Due to Enterobacter aerogenes Subsequent to Resection of Acoustic Neuroma and Percutaneous Endoscopic Gastrostomy Tube Placement: A Rare Nosocomial Event

Infection Control and Hospital Epidemiology ◽

10.1086/502135 ◽

2003 ◽

Vol 24 (10) ◽

pp. 780-782 ◽

Cited By ~ 2

Author(s):

David M. Poetker ◽

Charles E. Edmiston ◽

Michelle M. Smith ◽

Glenn A. Meyer ◽

Phillip A. Wackym

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Acoustic Neuroma ◽

Enterobacter Aerogenes ◽

Intervention Strategies ◽

Gastrostomy Tube ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Gastrostomy Tube Placement ◽

Peg Tube

AbstractWe present a case of meningitis after percutaneous endoscopic gastrostomy (PEG) tube placement subsequent to acoustic neuroma resection and cranioplasty. Four days following PEG tube placement the patient developed Enterobacter aerogenes meningitis, requiring explantation of infected cranioplasty material. His condition subsequently improved. Etiology and future intervention strategies are discussed (Infect Control Hosp Epidemiol 2003;24:780-782).

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Early Initiation of Enteral Feeding After Percutaneous Endoscopic Gastrostomy Tube Placement

Nutrition in Clinical Practice ◽

10.1177/0115426502017002123 ◽

2002 ◽

Vol 17 (2) ◽

pp. 123-125 ◽

Cited By ~ 18

Author(s):

Srinivasan Dubagunta ◽

Christopher D. Still ◽

Arvind Kumar ◽

Zahoor Makhdoom ◽

Nicholas A. Inverso ◽

...

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Enteral Feeding ◽

Early Initiation ◽

Gastrostomy Tube ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Gastrostomy Tube Placement

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Percutaneous Endoscopic Gastrostomy tube placement in COVID‐19 patients: Multidisciplinary approach

Digestive Endoscopy ◽

10.1111/den.13873 ◽

2020 ◽

Vol 33 (1) ◽

pp. 209-209

Author(s):

Hemant Goyal ◽

Abhilash Perisetti ◽

Benjamin Tharian

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Multidisciplinary Approach ◽

Gastrostomy Tube ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Gastrostomy Tube Placement

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Bronchoscope-Guided Percutaneous Endoscopic Gastrostomy Tube Placement by Interventional Pulmonologists: A Feasibility and Safety Study

Journal of Intensive Care Medicine ◽

10.1177/0885066618800275 ◽

2018 ◽

Vol 35 (9) ◽

pp. 851-857 ◽

Cited By ~ 1

Author(s):

Erik Folch ◽

Fayez Kheir ◽

Amit Mahajan ◽

Daniel Alape ◽

Omar Ibrahim ◽

...

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Percutaneous Tracheostomy ◽

Gastrostomy Tube ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Increased Risk ◽

Tube Removal ◽

Gastrostomy Tube Placement ◽

Peg Tube

Background: Percutaneous endoscopic gastrostomy (PEG) tube placement is a procedure frequently done in the intensive care unit. The use of a traditional endoscope can be difficult in cases of esophageal stenosis and theoretically confers an increased risk of infection due to its complex architecture. We describe a technique using the bronchoscope, which allows navigation through stenotic esophageal lesions and also minimizes the risk of endoscopy-associated infections. Methods: Prospective series of patients who had PEG tube placement guided by a bronchoscope. Procedural outcomes including successful placement, duration of the entire procedure, time needed for passage of the bronchoscope from the oropharynx to the major curvature, PEG tube removal rate, and mortality were collected. Procedural adverse events, including infections and long-term PEG-related complications, were recorded. Results: A total of 84 patients underwent bronchoscope-guided PEG tube placement. Percutaneous endoscopic gastrostomy tube insertion was completed successfully in 82 (97.6%) patients. Percutaneous endoscopic gastrostomy tube placement was performed immediately following percutaneous tracheostomy in 82.1%. Thirty-day mortality and 1-year mortality were 11.9% and 31%, respectively. Overall, minor complications occurred in 2.4% of patients, while there were no major complications. No serious infectious complications were identified and no endoscope-associated hospital acquired infections were documented. Conclusions: The use of the bronchoscope can be safely and effectively used for PEG tube placement. The use of bronchoscope rather than a gastroscope has several advantages, which include the ease of navigating through complex aerodigestive disorders such as strictures and fistulas as well as decreased health-care utilization. In addition, it may have a theoretical advantage of minimizing infections related to complex endoscopes.

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Percutaneous Endoscopic Gastrostomy Tube Placement: A Single Center Experience

Journal of Digestive Endoscopy ◽

10.1055/s-0039-3401391 ◽

2019 ◽

Vol 10 (03) ◽

pp. 150-154

Author(s):

Ankur Gupta ◽

Anil K. Singh ◽

Deepak Goel ◽

Akash N. Gaind ◽

Shireesh Mittal

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Enteral Feeding ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Single Center Experience ◽

Endoscopic Gastrostomy ◽

Neurologic Disorders ◽

Swallowing Difficulty ◽

Procedural Success ◽

Peg Tube

Abstract Introduction Percutaneous endoscopic gastrostomy (PEG) tube placement is one of the recommended methods for providing enteral feeding in patients with swallowing difficulty and intact gastrointestinal tract. We review our three years of experience pertaining to PEG placement in our hospital. Methods Records of all the patients, who underwent PEG between May 2014 to September 2017, were reviewed and relevant clinical and procedural details were noted. For all the patients, the procedure was conducted under antibiotic prophylaxis, moderate sedation, and local anesthesia. The PEG tube was placed by the “pull up” method. Telephonic follow-up of the patients was carried out after one month of study completion. Results The PEG tube was placed in 73 patients (male 51 [69.9%]; age median [range] 67 [16–91] years). PEG was placed in 42 patients with stroke (57.6%), other neurologic disorders 17 (23.3%), coma due to head injury 5 (6.8%), and terminal malignancy 9 (12.3%). Technical success was achieved in 73 (97%) patients. Eleven procedure-related complications occurred in nine patients (15.5%) including one death due to peritonitis. Of the 57 patients, who could be followed-up after discharge, 41 died of their primary illness after 65 (1–751) days, nine were alive and continuing on PEG tube feed, and in seven PEG was removed because it was not needed. Conclusion PEG is a useful procedure for enteral feeding. Although procedural success is high, it may be accompanied by significant complications.

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