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Prognostic significance of intragastric pressure for the occurrence of aspiration pneumonia in the patients with percutaneous endoscopic gastrostomy (PEG).

Autor – Kudo M, Kanai N, Hirasawa T, Asao T, Kuwano H.

Zeitschrift/Erscheinungsdatum – Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1935-8.

STUDY OBJECTIVES:

BACKGROUND/AIMS: Patients who have undergone a percutaneous endoscopic gastrostomy have been increasing. However, complications in serious patients are encountered more frequently. We attempted to examine the simple and new technique for the purpose of preventing complications in percutaneous endoscopic gastrostomy patients. By using our method of measuring of the intragastric pressure during the fasting period, the aspiration pneumonia of percutaneous endoscopic gastrostomy patient could be estimated. METHODOLOGY: From January 2003 to December 2005, one hundred and thirty-two consecutive patients were examined. The intragastric pressure is measured by using a percutaneous endoscopic gastrostomy tube. This method is referenced as the technique for measuring the intra-abdominal pressure which is measured in the case of the abdominal compartment syndrome and the central venous pressure. RESULTS: The mean intragastric pressure of patients with complicated pneumonia was 10.4 +/- 7.1 cm H2O, and 4.7 +/- 4.5 cm H2O with non-complicated pneumonia (p=0.0001). In cases of the patients in whom the tube immediately becomes dirty, the mean intragastric pressure was higher than in clean cases (p=0.0005). CONCLUSIONS: There is a relationship between the intragastric pressure and the incidence of complications such as aspiration pneumonia. Our simple and easy technique can estimate the aspiration pneumonia.