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The provision of a percutaneously placed enteral tube feeding service.
Gut. 2010 Dec; 59(12):1592-605.Gut

Abstract

There is overwhelming evidence that the maintenance of enteral feeding is beneficial in patients in whom oral access has been diminished or lost. Short-term enteral access is usually achieved via naso-enteral tube placement. For longer term tube feeding there are recognised advantages for enteral feeding tubes placed percutaneously. The provision of a percutaneous enteral tube feeding service should be within the remit of the hospital nutrition support team (NST). This designated team should provide a framework for patient selection, pre-assessment and post-procedural care. Close working relations with community-based services should be established. An accredited therapeutic endoscopist should be a member of the NST and direct the technical aspects of the service. Every endoscopy unit in an acute hospital setting should provide a basic percutaneous endoscopic gastrostomy (PEG) service. This should include provision for fitting a PEG jejunal extension (PEGJ) if required. Specialist units should be identified where a more comprehensive service is provided, including direct jejunal placement (DPEJ), as well as radiological and laparoscopically placed tubes. Good understanding of the indications for percutaneous enteral tube feeding will prevent inappropriate procedures and ensure that the correct feeding route is selected at the appropriate time. Each unit should adopt and become familiar with a limited range of PEG tube equipment. Careful adherence to the important technical details of tube insertion will reduce peri-procedural complications. Post-procedural complications remain relatively common, however, and an awareness of the correct approach to managing them is essential for all clinicians involved in providing a percutaneous enteral tube feeding service. Finally, ethical considerations should always be taken into account when considering long-term enteral feeding, especially for patients with a poor quality of life.

Authors+Show Affiliations

Department of Gastroenterology Hammersmith Hospital Site, Imperial College Healthcare NHS Trust, London W12 0HS, UK. david.westaby@imperial.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Practice Guideline

Language

eng

PubMed ID

21071581

Citation

Westaby, David, et al. "The Provision of a Percutaneously Placed Enteral Tube Feeding Service." Gut, vol. 59, no. 12, 2010, pp. 1592-605.
Westaby D, Young A, O'Toole P, et al. The provision of a percutaneously placed enteral tube feeding service. Gut. 2010;59(12):1592-605.
Westaby, D., Young, A., O'Toole, P., Smith, G., & Sanders, D. S. (2010). The provision of a percutaneously placed enteral tube feeding service. Gut, 59(12), 1592-605. https://doi.org/10.1136/gut.2009.204982
Westaby D, et al. The Provision of a Percutaneously Placed Enteral Tube Feeding Service. Gut. 2010;59(12):1592-605. PubMed PMID: 21071581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The provision of a percutaneously placed enteral tube feeding service. AU - Westaby,David, AU - Young,Alison, AU - O'Toole,Paul, AU - Smith,Geoff, AU - Sanders,David S, PY - 2010/11/13/entrez PY - 2010/11/13/pubmed PY - 2010/12/14/medline SP - 1592 EP - 605 JF - Gut JO - Gut VL - 59 IS - 12 N2 - There is overwhelming evidence that the maintenance of enteral feeding is beneficial in patients in whom oral access has been diminished or lost. Short-term enteral access is usually achieved via naso-enteral tube placement. For longer term tube feeding there are recognised advantages for enteral feeding tubes placed percutaneously. The provision of a percutaneous enteral tube feeding service should be within the remit of the hospital nutrition support team (NST). This designated team should provide a framework for patient selection, pre-assessment and post-procedural care. Close working relations with community-based services should be established. An accredited therapeutic endoscopist should be a member of the NST and direct the technical aspects of the service. Every endoscopy unit in an acute hospital setting should provide a basic percutaneous endoscopic gastrostomy (PEG) service. This should include provision for fitting a PEG jejunal extension (PEGJ) if required. Specialist units should be identified where a more comprehensive service is provided, including direct jejunal placement (DPEJ), as well as radiological and laparoscopically placed tubes. Good understanding of the indications for percutaneous enteral tube feeding will prevent inappropriate procedures and ensure that the correct feeding route is selected at the appropriate time. Each unit should adopt and become familiar with a limited range of PEG tube equipment. Careful adherence to the important technical details of tube insertion will reduce peri-procedural complications. Post-procedural complications remain relatively common, however, and an awareness of the correct approach to managing them is essential for all clinicians involved in providing a percutaneous enteral tube feeding service. Finally, ethical considerations should always be taken into account when considering long-term enteral feeding, especially for patients with a poor quality of life. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/21071581/The_provision_of_a_percutaneously_placed_enteral_tube_feeding_service_ DB - PRIME DP - Unbound Medicine ER -