Reasons of PEG failure to eliminate gastroesophageal reflux in mechanically ventilated patients.
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Date
2009-11-21ICR Author
Author
Douzinas, EE
Andrianakis, I
Livaditi, O
Bakos, D
Flevari, K
Goutas, N
Vlachodimitropoulos, D
Tasoulis, M-K
Betrosian, AP
Type
Journal Article
Metadata
Show full item recordAbstract
AIM: To investigate factors predicting failure of percutaneous endoscopic gastrostomy (PEG) to eliminate gastroesophageal reflux (GER). METHODS: Twenty-nine consecutive mechanically ventilated patients were investigated. Patients were evaluated for GER by pH-metry pre-PEG and on the 7th post-PEG day. Endoscopic and histologic evidence of reflux esophagitis was also carried out. A beneficial response to PEG was considered when pH-metry on the 7th post-PEG day showed that GER was below 4%. RESULTS: Seventeen patients responded (RESP group) and 12 did not respond (N-RESP) to PEG. The mean age, sex, weight and APACHE II score were similar in both groups. GER (%) values were similar in both groups at baseline, but were significantly reduced in the RESP group compared with the N-RESP group on the 7th post-PEG day [2.5 (0.6-3.8) vs 8.1 (7.4-9.2, P < 0.001)]. Reflux esophagitis and the gastroesophageal flap valve (GEFV) grading differed significantly between the two groups (P = 0.031 and P = 0.020, respectively). Histology revealed no significant differences between the two groups. CONCLUSION: Endoscopic grading of GEFV and the presence of severe reflux esophagitis are predisposing factors for failure of PEG to reduce GER in mechanically ventilated patients.
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Subject
Humans
Gastroesophageal Reflux
Esophagitis, Peptic
Gastroscopy
Esophagoscopy
Endoscopy
Treatment Outcome
Respiration, Artificial
Enteral Nutrition
Gastrostomy
Hydrogen-Ion Concentration
Adult
Aged
Middle Aged
Female
Male
Language
eng
Date accepted
2009-11-01
Citation
World journal of gastroenterology, 2009, 15 (43), pp. 5455 - 5460
Publisher
BAISHIDENG PUBLISHING GROUP INC