A Survey of Percutaneous Endoscopic Gastrostomy Procedures in The Intensive Care Units of Turkey

Abstract

Objective: Percutaneous endoscopic gastrostomy (PEG) is one of the most frequent procedures performed in the intensive care unit. There is no national study in day about the practice patterns of clinicians so we aimed to evaluate the most common indications and complications associated with PEG feeding and to detect variability in pratices of sedation, antibiotic prophylaxis and nutritional support protocols. Methods: A survey was sent randomly to clinicians working in national intensive care units in Turkey. The survey, which consisted of 23 questions, had 101 responders. Results: The main indication for PEG was prolonged nasogastric tube feeding. The most frequent complication was periostomal leak. The PEG tubes were most frequently placed 4-6 weeks after ICU admission. The majority reinitiated enteral feeding 24 hours after the procedure and about half initiated parenteral nutrition support in the fasting period in order to avoid inadequate calorie intake. Regarding antibiotic use before PEG, 61,4% of clinicians claimed to use prophylactic antibiotics. When asked about pre-procedural antiplatelet drugs, 59% of clinicians reported to cessate acetylsalicylic acid. Conclusion: Among intensive care units, there are differences regarding the placement of PEG tubes and there is no spesific algorythm about the procedure. More definitive recommendations about PEG procedure and periprocedural care are in need.