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

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

作     者:Emmanuel E Douzinas Andreas Tsapalos Antonios Dimitrakopoulos Evanthia Diamanti-Kandarakis Alexandros D Rapidis Charis Roussos 

作者机构:Department of Critical CareEvangelismos HospitalUniversity of AthensMedical SchoolAthens 10675Greece Eginition HospitalUniversity of AthensMedical SchoolAthens 11528Greece Department ot Internal MedicineLaiko HospitalUniversity of AthensMedical SchoolAthens 11527Greece Head and Neck UnitGreek Anticancer InstituteAthens 11522Greece 

出 版 物:《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文版))

年 卷 期:2006年第12卷第1期

页      面:114-118页

核心收录:

学科分类:1002[医学-临床医学] 100201[医学-内科学(含:心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主  题:Nasogastric tube Gastroesophageal reflux Semi-recumbency Gastric residue Percutaneous endoscopic gastrostomy. 

摘      要:AIM: To investigate the effect of percutaneous endoscopic gastrostomy (PEG) on gastroesophageal reflux (GER) in mechanically-ventilated patients. METHODS : In a prospective, randomized, controlled study 36 patients with recurrent or persistent ventilatorassociated 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. RESULTS: 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). CONCLUSION: Gastrostomy when combined with semi- recumbent position and absence of nutrient gastric residue reduces the gastroesophageal reflux in ventilated patients.

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