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Percutaneous Endoscopic Gastrostomy

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Interventional Critical Care

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Abstract

Percutaneous endoscopic gastrostomy (PEG) tube placement is a relatively new procedure that is commonly performed at the bedside in critically ill patients requiring long-term enteral access. Often utilized in cases of trauma, brain injury, or chronic illness, it is a much safer alternative for enteral feeding than the previously prescribed open surgical gastrostomy tube and superior to long-term use of a nasogastric tube. This procedure can be performed at the bedside, often in the intensive care unit (ICU), and requires at least two proceduralists. This positions the advanced care practitioner (ACP) working in the ICU as the ideal candidate to function in either the endoscopist or the operator role. Complication rates of the procedure are overall low and can be associated with either the endoscopy or the placement of the tube itself. With proper patient selection, education, and experience, beside PEG placement can be safely performed in ICUs making it a popular alternative to open gastrostomy tube when long-term enteral feeds are prescribed.

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Abbreviations

PEG:

Percutaneous endoscopic gastrostomy

GI:

Gastrointestinal

ACP:

Advance care provider

ICU:

Intensive care unit

NGT:

Nasogastric tube

OG:

Orogastric tube

INR:

International normalized ratio

mm3 :

Millimeters cubed

BMI:

Body mass index

Kg:

Kilogram

m2 :

Meter squared

CT:

Computerized tomography

BBS:

Buried bumper syndrome

RCP:

Respiratory care practitioner

cm:

Centimeter

mL:

Milliliter

NPO:

Nil per os

ASGE:

American Society for Gastrointestinal Endoscopy

EGD:

Esophagogastroduodenoscopy

mcg:

Microgram

mg:

Milligram

IV:

Intravenous

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Authors and Affiliations

  1. Department of Surgery, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT, 06105, USA

    Peter S. Sandor RRT, MHSPA-C & James E. Lunn RRT, MHS, PA-C

  2. Yale-New Haven Hospital – St Raphael Campus, 1450 Chapel Street, New Haven, CT, 06511, USA

    Brennan Bowker MHS, PA-C

Authors
  1. Peter S. Sandor RRT, MHSPA-C
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  2. Brennan Bowker MHS, PA-C
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  3. James E. Lunn RRT, MHS, PA-C
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Corresponding author

Correspondence to Peter S. Sandor RRT, MHSPA-C .

Editor information

Editors and Affiliations

  1. Carolinas HealthCare System, Charlotte, North Carolina, USA

    Dennis A. Taylor

  2. Department of Surgery, Oregon Health and Sciences University, Portland, Oregon, USA

    Scott P. Sherry

  3. Carolinas HealthCare System, Charlotte, North Carolina, USA

    Ronald F. Sing

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© 2016 Springer International Publishing Switzerland

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Sandor, P.S., Bowker, B., Lunn, J.E. (2016). Percutaneous Endoscopic Gastrostomy. In: Taylor, D., Sherry, S., Sing, R. (eds) Interventional Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-25286-5_29

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  • DOI: https://doi.org/10.1007/978-3-319-25286-5_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25284-1

  • Online ISBN: 978-3-319-25286-5

  • eBook Packages: MedicineMedicine (R0)

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