Percutaneous endoscopic gastrostomy feeding in patients with cystic fibrosis

Background-Malnutrition is a common management problem in patients with cys tic fibrosis (CF). Various approaches to supplemental nutrition by both par enteral and enteral routes have been used. Aim-To analyse the efficacy and acceptability of supplemental overnight fee ding using a percutaneous endoscopic gastrostomy (PEG) in patients with CE Patients-53 patients with CF (43 adults; age >17 years) with severe pulmona ry disease. Methods-The technical success and complications of PEG insertion were docum ented together with changes in nutritional and pulmonary status of the coho rt. Results-PEG tubes were successfully inserted in all patients, with immediat e complications (respiratory depression) in two (4%) and late complications in 13 (25%). Feeding was well tolerated by 50/51 (98%) of the cohort durin g a mean (SEM) follow up of 14.5 (2.1) months. The adult cohort had a signi ficant increase in weight and body mass index at six months which was maint ained at 12 months. Serum albumin concentration remained stable at six mont hs but had fallen by 12 months, although the differences were not statistic ally significant. These results were reflected in the paediatric cohort. Pu lmonary function in those followed up for one year had apparently stabilise d, but the number of admissions to hospital over the year before and the ye ar after PEG did not change. Half of the cohort were accepted for heart-lun g/lung transplantation, the improvement in nutritional status being a prere quisite for this. Conclusion-Supplemental PEG tube feeding is well tolerated and results in a significant improvement in nutritional status and an apparent stabilisatio n of pulmonary function in severely malnourished CF patients with advanced pulmonary disease.