Solunum Yoğun Bakım Ünitesinde Perkütan Endoskopik Gastrostominin Klinik Sonuçları

Year 2023, , 782 - 785, 30.09.2023

Kamuran Uluç , Esra Akkütük Öngel , Nazan Köylü İlkaya , Özkan Devran , Ernur Ay , Hatice Kutbay Özçelik

https://doi.org/10.16899/jcm.1331937

Abstract

Amaç: Perkütan endoskopik gastrostomi (PEG), 2-3 haftadan daha uzun süreli enteral beslenmeye ihtiyaç duyması beklenen hastalarda kullanılan beslenme yöntemidir. Yoğun bakım ünitemizde takip ettiğimiz ve beslenmelerini PEG açarak sağladığımız hastalarda PEG endikasyonlarını, komplikasyonlarını ve işlem sonrası hasta prognozlarını değerlendirmeyi amaçladık.
Gereç ve Yöntem: Hastanemiz Solunum Yoğun Bakım Ünitesinde 1 Ocak 2017 – 31 Aralık 2022 tarihleri arasında PEG uyguladığımız 51 hastayı retrospektif olarak incelendi.
Bulgular: PEG uygulanan hastaların 30’u (%58) erkekti. Hastaların yaş ortalaması 63,9 (min 23-max 90)du. Hastaların Glasgow koma skalası (GKS) ortalaması 8,47, Akut Fizyoloji ve Kronik Sağlık Değerlendirme II (APACHE II) skoru ortalaması 22, Sepsis İlişkili Organ Yetmezliği Değerlendirmesi (SOFA) skoru ortalaması 7,45, PEG açılma günü ortalaması 24,8, yoğun bakım yatış gün ortalaması 48,8 di. Hastaların 21’ine (%41,2) Serobrovasküler hastalık( SVH), 19’una (%37,3) Alzhemier/ Demans/ Parkinson , 18’ine (35,3) uzamış mekanik ventilasyon nedeniyle PEG açıldı. PEG komplikasyon oranı %13,7 idi. PEG açılan hastaların 35’i (%68,6) taburcu, 16’sı (%31,4) exitus oldu.
Sonuç: Hasta başında kolayca uygulanabilmesi, komplikasyon ve mortalite oranlarının son derece az olması nedeniyle özellikle oral alımı yeterli olmayan yoğun bakım hastalarında enteral tedavilerin sürdürülebilmesi için PEG takılması uygundur.

Keywords

Perkütan endoskopik gastrostomi, yoğun bakım ünitesi, endikasyon ve komplikasyon, prognoz, nutrisyon

Clinical Outcomes of Percutaneous Endoscopic Gastrostomy in the Respiratory Intensive Care Unit

Abstract

Aim: Percutaneous endoscopic gastrostomy (PEG) is a feeding method used in patients who are expected to require enteral nutrition for more than 2-3 weeks. We aimed to evaluate PEG indications, complications, and post-procedural patient prognosis in patients followed up in our intensive care unit and fed via PEG.
Materials and Methods: We retrospectively reviewed 51 patients receiving PEG between January 1, 2017, and December 31, 2022, in the Respiratory Intensive Care Unit.
Results: Among the patients receiving PEG, 30 (58%) were male. The average age was 63.9, ranging from 23 to 90. The mean scores for the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sepsis Related Organ Failure Assessment (SOFA) were 8.47, 22, and 7.45, respectively. The mean duration until PEG placement was 24.8 days, and the average intensive care unit (ICU) hospitalization was 48.8 days.PEG was performed in 21 patients (41.2%) due to cerebrovascular disease, in 19 patients (37.3%) due to Alzheimer, dementia, or Parkinson's disease, and 18 patients (35.3%) due to prolonged mechanical ventilation. The complication rate associated with PEG was 13.7%. Among the patients who underwent PEG, 35 (68.6%) were discharged, while 16 (31.4%) died.
Conclusion: Considering its easy use at bedside, low complication, and mortality rates, PEG insertion is appropriate for continuing enteral therapies, especially in intensive care patients with insufficient oral intake.

Keywords

Percutaneous endoscopic gastrostomy, intensive care unit, indications and complications, prognosis, nutrition

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