Routine intragastric feeding following traumatic brain injury is safe and well tolerated

BACKGROUND: Delayed gastric emptying following traumatic brain injury (TBI) has led some to advocate jejunal feeding. Our purpose was to review our ex perience with percutaneous endoscopic gastrostomy (PEG) and intragastric fe eding in TBI patients to assess safety and effectiveness. METHODS: Ail patients on a TBI clinical pathway at our institution were tar geted for early PEG. After PEG, standard enteral nutrition was initiated. A bdominal examination and gastric residual volumes were used to assess toler ance. RESULTS: There were 118 patients with moderate to severe TBI. The average a ge was 36 years. Mean Injury Severity Score (ISS) was 25. Enteral access wa s obtained and intragastric feeding was initiated on day 3.6. Intragastric feeding was tolerated without complication in 111 of 114 (97%) patients. Fi ve patients aspirated, but had no evidence of intolerance prior to the even t. CONCLUSIONS: PEG provided reliable enteral access in moderate to severe TBI patients. Intragastric feeding was well tolerated with a low complication rate (4%). (C) 2000 by Excerpta Medica, Inc.