Effect of percutaneous endoscopic gastrostomy on gastro-esophageal reflux in mechanically-ventilated patients

To investigate the effect of percutaneous endoscopic gastrostomy (PEG) on gastroesophageal reflux (GER) in mechanically-ventilated patients. In a prospective, randomized, controlled study 36 patients with recurrent or persistent ventilator-associated pneumonia (VAP) and GER > 6% were divided into...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2006-01, Vol.12 (1), p.114-118
Main Authors: Douzinas, Emmanuel E, Tsapalos, Andreas, Dimitrakopoulos, Antonios, Diamanti-Kandarakis, Evanthia, Rapidis, Alexandros D, Roussos, Charis
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Gastroesophageal Reflux - prevention & control
Gastroscopy
Gastrostomy - methods
Humans
Intubation, Gastrointestinal
Male
Middle Aged
Posture
Prospective Studies
Rapid Communication
Respiration, Artificial
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Summary:To investigate the effect of percutaneous endoscopic gastrostomy (PEG) on gastroesophageal reflux (GER) in mechanically-ventilated patients. In a prospective, randomized, controlled study 36 patients with recurrent or persistent ventilator-associated pneumonia (VAP) and GER > 6% were divided into PEG group (n = 16) or non-PEG group (n = 20). Another 11 ventilated patients without reflux (GER < 3%) served as control group. Esophageal pH-metry was performed by the "pull through" method at baseline, 2 and 7 d after PEG. Patients were strictly followed up for semi-recumbent position and control of gastric nutrient residue. A significant decrease of median (range) reflux was observed in PEG group from 7.8 (6.2 - 15.6) at baseline to 2.7 (0 - 10.4) on d 7 post-gastrostomy (P < 0.01), while the reflux increased from 9 (6.2 - 22) to 10.8 (6.3 - 36.6) (P < 0.01) in non-PEG group. A significant correlation between GER (%) and the stay of nasogastric tube was detected (r = 0.56, P < 0.01). Gastrostomy when combined with semi-recumbent position and absence of nutrient gastric residue reduces the gastroesophageal reflux in ventilated patients.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v12.i1.114