PERCUTANEOUS ENDOSCOPIC GASTROSTOMY FOR PATIENTS WITH SEVERE CEREBRALINJURY

Early enteral nutrition improves the outcome of severely injured patie nts. To provide enteral nutrition, various methods are available. In a retrospective study we analysed the outcome of 24 severely traumatize d patients (mean ISS = 44), in whom a percutaneous endoscopic gastrost omy (PEG) tons used for enteral nutrition. All patients had been admit ted to the intensive care unit with major cerebral injury. The mean du ration of intensive care treatment and the in hospital stay were 28 an d 71 days, respectively. PEG was introduced 14 days after hospital adm ittance, Enteral nutrition through the PEG was administered for 45 day s. Four patients died, 8 patients were discharged from the hospital wh ile being fed via the PEG and 12 patients resumed normal feeding and t he PEG eons removed. Three severe complications occurred 1 patient asp irated massively and died; in 2 patients intra-abdominal leakage of th e enteral nutrition occurred. Both patients recovered from this compli cation. We conclude that because of the advantages of early enteral nu trition on the one hand and the drawbacks of nasogastric feeding tubes on the other; in injured patients with severe cerebral damage, PEG pl acement is justified, despite the risk of complications. (C) 1998 Else vier Science Ltd. All rights reserved.