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 patie...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.展开更多
文摘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.