Findings of New Study May Reduce Enteral Nutrition Problems

March 30, 2009

Researchers in Japan have identified predictive factors for enteral nutrition problems following percutaneous endoscopic gastrostomy.

Researchers in Japan have identified predictive factors for enteral nutrition problems following percutaneous endoscopic gastrostomy (PEG).

The team, from the Aichi Medical University School of Medicine in Aichi, and Asahikawa Rehabilitation Hospital in Asahikawa, Japan, performed the study in an attempt to discover problems patients may encounter with feeding tubes after a PEG has been performed.

The possible causes for problems were discussed as both independent factors, based on the history of the individual patient, and factors that were determined as a result of the PEG.

The independent factors that the researchers identified were esophageal hiatal hernia presence, history of paralytic ileus, and chronic renal dysfunction presence, article on the study. Additionaly, the use of enteral nutrition before a gastrectomy was identified as a risk reduction factor.

Of the 252 patients in the study, 44 (Criterion 1) experienced enteral nutrition problems after PEG, with a majority taking about 69 days to switch to enteral nutrition. In these cases, aspiration pneumonia, paralytic ileus, and acute enterocolitis were the three most common complications.

The remaining patients (Criterion 2) who did not switch to enteral nutrition and instead used “other nutritional methods,” also experienced aspiration pneumonia, paralytic ileus, and acute enterocolitis as the most common complications.

For those in Criterion 1 with pneumonia and acute enterocolitis, “aspiration pneumonia and Clostridium difficile-associated enteric disease (CDED) accounted for the majority of the cases, respectively.” In the Criterion 2 group, “aggravation of chronic renal dysfunction and heart failure were noted.”

The researchers concluded that enteral nutrition problems after PEG “occurred at a comparatively high rate.” Collecting patient histories made the four independent factors previously mentioned a much more foreseeable problem. The researchers add that, “since specific causes exist for these predictors, it may be possible to analyze causal relationships and mechanisms of onset, thereby making it possible to devise several preventive methods.”