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Maximizing tolerance of enteral nutrition in severely injured trauma patients: a comparison of enteral feedings by means of percutaneous endoscopic gastrostomy versus percutaneous endoscopic gastrojejunostomy.
J Trauma. 2000 Mar; 48(3):459-64; discussion 464-5.JT

Abstract

BACKGROUND

Intolerance of enteral nutrition interrupts caloric balance and increases hospital costs. This study proposes that enteral feeding by percutaneous endoscopic gastrojejunostomy (PEGJ) provides continuous uninterrupted nutrition with greater consistency than percutaneous endoscopic gastrostomy (PEG).

METHODS

This prospective nonrandomly assigned study was conducted at a Level I trauma center from December of 1997 through October of 1998. All feeding tubes were placed by trauma/critical care surgeons for nutritional support. Feeding course was monitored for 14 days from time of tube placement. Demographic data and outcome variables compared were age, sex, Injury Severity Score, Abbreviated Injury Score, hospital length of stay, number of days to reach nutritional goal feedings, caloric goal, protein goal, cc/hr at goal, total parenteral nutrition usage, complications, and hospital charges. Statistical analyses used the independent samples t test, Cox regression, and Pearson chi2 with significance level set at 0.05.

RESULTS

Patients receiving enteral nutrition by PEGJ reached nutritional goal sooner than patients who received enteral nutrition by PEG (p = 0.02). Thirty-seven of 46 PEGJ patients (80%) were at goal rate at day 3, whereas 28 of 43 PEG patients (65%) were at goal on day 3. Nine of 43 PEG patients (21%) and 3 of 46 PEGJ patients (7%) failed to reach goal within 14 days.

CONCLUSION

This study suggests that enteral nutrition delivered by means of PEGJ is better tolerated than enteral nutrition delivered by means of PEG in trauma patients with no abdominal conditions that preclude percutaneous feeding tube placement.

Authors+Show Affiliations

Department of Surgery, University of Tennessee College of Medicine, Chattanooga 37403, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10744284

Citation

Adams, G F., et al. "Maximizing Tolerance of Enteral Nutrition in Severely Injured Trauma Patients: a Comparison of Enteral Feedings By Means of Percutaneous Endoscopic Gastrostomy Versus Percutaneous Endoscopic Gastrojejunostomy." The Journal of Trauma, vol. 48, no. 3, 2000, pp. 459-64; discussion 464-5.
Adams GF, Guest DP, Ciraulo DL, et al. Maximizing tolerance of enteral nutrition in severely injured trauma patients: a comparison of enteral feedings by means of percutaneous endoscopic gastrostomy versus percutaneous endoscopic gastrojejunostomy. J Trauma. 2000;48(3):459-64; discussion 464-5.
Adams, G. F., Guest, D. P., Ciraulo, D. L., Lewis, P. L., Hill, R. C., & Barker, D. E. (2000). Maximizing tolerance of enteral nutrition in severely injured trauma patients: a comparison of enteral feedings by means of percutaneous endoscopic gastrostomy versus percutaneous endoscopic gastrojejunostomy. The Journal of Trauma, 48(3), 459-64; discussion 464-5.
Adams GF, et al. Maximizing Tolerance of Enteral Nutrition in Severely Injured Trauma Patients: a Comparison of Enteral Feedings By Means of Percutaneous Endoscopic Gastrostomy Versus Percutaneous Endoscopic Gastrojejunostomy. J Trauma. 2000;48(3):459-64; discussion 464-5. PubMed PMID: 10744284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maximizing tolerance of enteral nutrition in severely injured trauma patients: a comparison of enteral feedings by means of percutaneous endoscopic gastrostomy versus percutaneous endoscopic gastrojejunostomy. AU - Adams,G F, AU - Guest,D P, AU - Ciraulo,D L, AU - Lewis,P L, AU - Hill,R C, AU - Barker,D E, PY - 2000/4/1/pubmed PY - 2000/4/15/medline PY - 2000/4/1/entrez SP - 459-64; discussion 464-5 JF - The Journal of trauma JO - J Trauma VL - 48 IS - 3 N2 - BACKGROUND: Intolerance of enteral nutrition interrupts caloric balance and increases hospital costs. This study proposes that enteral feeding by percutaneous endoscopic gastrojejunostomy (PEGJ) provides continuous uninterrupted nutrition with greater consistency than percutaneous endoscopic gastrostomy (PEG). METHODS: This prospective nonrandomly assigned study was conducted at a Level I trauma center from December of 1997 through October of 1998. All feeding tubes were placed by trauma/critical care surgeons for nutritional support. Feeding course was monitored for 14 days from time of tube placement. Demographic data and outcome variables compared were age, sex, Injury Severity Score, Abbreviated Injury Score, hospital length of stay, number of days to reach nutritional goal feedings, caloric goal, protein goal, cc/hr at goal, total parenteral nutrition usage, complications, and hospital charges. Statistical analyses used the independent samples t test, Cox regression, and Pearson chi2 with significance level set at 0.05. RESULTS: Patients receiving enteral nutrition by PEGJ reached nutritional goal sooner than patients who received enteral nutrition by PEG (p = 0.02). Thirty-seven of 46 PEGJ patients (80%) were at goal rate at day 3, whereas 28 of 43 PEG patients (65%) were at goal on day 3. Nine of 43 PEG patients (21%) and 3 of 46 PEGJ patients (7%) failed to reach goal within 14 days. CONCLUSION: This study suggests that enteral nutrition delivered by means of PEGJ is better tolerated than enteral nutrition delivered by means of PEG in trauma patients with no abdominal conditions that preclude percutaneous feeding tube placement. SN - 0022-5282 UR - https://www.unboundmedicine.com/medline/citation/10744284/Maximizing_tolerance_of_enteral_nutrition_in_severely_injured_trauma_patients:_a_comparison_of_enteral_feedings_by_means_of_percutaneous_endoscopic_gastrostomy_versus_percutaneous_endoscopic_gastrojejunostomy_ L2 - http://dx.doi.org/10.1097/00005373-200003000-00014 DB - PRIME DP - Unbound Medicine ER -