Gyu Young Pih, Hee Kyong Na, Suk-Kyung Hong, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Clin Endosc 2020;53(6):705-716. Published online March 31, 2020
Background /Aims: Percutaneous endoscopic gastrostomy (PEG) is usually performed on patients with chronic underlying diseases in the general ward (GW). This study evaluated the clinical outcomes of PEG performed on patients in the surgical intensive care unit (SICU) compared with those of PEG performed in the GW.
Methods The medical records of 27 patients in the SICU and 263 in the GW, who underwent PEG between January 2013 and July 2017, were retrospectively reviewed.
Results The median age of the 27 SICU patients was 66 years, and their median body mass index was 21.1 kg/m2. In the SICU group, the median baseline Sequential Organ Failure Assessment (SOFA) score was 4, and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 16. The median interval between surgery and PEG in SICU patients was 30 days, with a PEG failure rate of 3.7%. Acute complications in SICU patients included bleeding (7.4%) and ileus (11.1%), while chronic complications included aspiration pneumonia (7.4%) and tube obstruction (3.7%). The rates of acute and chronic complications did not differ significantly between the SICU and GW groups. The 30-day mortality rate was 14.8% in SICU patients and 5.3% in GW patients (p=0.073).
Conclusions PEG is a safe and feasible method of enteral feeding for critically ill patients who require ICU care after surgery.
Citations
Citations to this article as recorded by
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee Gut and Liver.2024; 18(1): 10. CrossRef
A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon Gut and Liver.2024; 18(1): 77. CrossRef
Clinical practice guidelines for percutaneous endoscopic gastrostomy Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee Clinical Endoscopy.2023; 56(4): 391. CrossRef
Risk factors and natural history of bedside percutaneous endoscopic versus fluoroscopy-guided gastrostomy tubes in intensive care unit patients Lucy Ching Chau, Ryan Soheim, Michael Dix, Sarah Chung, Nadia Obeid, Arielle Hodari-Gupta, Cletus Stanton Surgical Endoscopy.2023; 37(11): 8742. CrossRef
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef
Relative contraindications to percutaneous endoscopic gastrostomy (review of literature) Yu. O. Zharikov, M. Kh. Gurtsiev, S. Zh. Antonyan, S. F. Askerova, E. I. Chairkina, P. A. Yartsev Grekov's Bulletin of Surgery.2022; 180(6): 105. CrossRef
Seong Joon Koh, M.D., Jae Hee Cheon, M.D., Joo Sung Kim, M.D., Byong Duk Ye, M.D., Hae Yeon Kang, M.D., Bo Hyun Kim, M.D., Jeong Hoon Lee, M.D., Ki Young Yang, M.D., Sang Gyun Kim, M.D., Hyun Chae Jung, M.D. and In Sung Song, M.D.
Korean J Gastrointest Endosc 2006;32(5):320-325. Published online May 30, 2006
Background /Aims: To determine the incidence and risk factors associated with rebleeding after upper gastrointestinal bleeding (UGIB) in critically ill patients. Methods: This study retrospectively reviewed the medical records of 60 patients undergoing bedside esophagogastroduodenoscopy between April 2000 and February 2004 for UGIB that developed whilst in the intensive care unit (ICU). Results: Eight out of 60 patients died within 7 days, and an additional 7 patients died within 30 days after the initial bleeding. Two of these 15 patients (13.3%), died from GI bleeding. The 7-day and 30-day rebleeding rates were 34.6% (18/52 patients), and 51.1% (23/45 patients), respectively. Multiple logistic regression using the significant variables revealed, anemia (Hb<9.0 g/dL) and hypoalbuminemia (<3.0 g/dL) to be significant factor for 7-day rebleeding, and hypoxia (<80 mmHg), anemia (Hb<9.0 g/dL), blood transfusion (≥3 units) to be significant independent risk factor for 30-day rebleeding. Conclusions: The rebleeding rates in the ICU setting were as high as 34.6% at 7 days and 51.1% at 30 days. This suggests that the underlying conditions of the critically ill patients affect the rebleeding rate more than the endoscopic features. Therefore, adequate general ICU care including the prevention and correction of hypoxia, anemia, and hypoalbuminemia, and minimizing blood loss can reduce the risk of rebleeding after UGIB in an ICU setting. (Korean J Gastrointest Endosc 2006;32:320325)
Backgound/Aims: Gastrointestinal (GI) bleeding remains a common medical problem, with morbidity and mortality rates of GI bleeding in intensive care unit (ICU) believed to have remained unchanged. There has been no report about the etiology and clinical manifestation of GI bleeding in ICU in Korea. Therefore, we performed this study to determine the frequency, etiology, risk factors, and outcome of clinically significant GI bleeding that occurred after admission to ICU. Methods: We reviewed medical records of 1829 patients admitted to medical ICU in Samsung Medical Center from October 1994 to May 1999, Cases were enrolled the patients who developed GI bleeding more than 24 hours after admission to the medical ICU. The cases were compared with control populations: a set of ICU patients without GI bleeding matched with cases for age, gender, and length of ICU stay to evaluate the risk factors of GI bleeding. Results: Clinically significant GI bleeding, confirmed by endoscopy, occurred in 71 patients of 1,829 patients (3.9%) after a mean ICU stay of 14±2.6 days. Gastric ulcer bleeding was the most common source of GI bleeding, accounting for 29.6% of cases overall. There were no statistical differences in underlying disease, mechanical ventilator use, heparin or steroid use, prothrombin time, prophylactic drug use such as H₂. blocker and antacid use between cases and controls. However, thrombocytopenia (<50,000/mm³) was more common in cases who had GI bleeding than controls (P<0.05). Conclusions: Gastric ulcer was the most common cause of GI bleeding in ICU and careful attention was necessary to patients with thrombocytopenia (<50,000/mm³) in ICU.