Department of Neonatology, Morsani College of Medicine, University of South Florida, Tampa.
Division of Neonatology, Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, FL.
J Pediatr Gastroenterol Nutr. 2018 Jul;67(1):40-44. doi: 10.1097/MPG.0000000000001906.
The aim of the study is to describe the safety and efficacy of bedside percutaneous endoscopic gastrostomy (PEG) placement in a level 3 neonatal intensive care unit (NICU).
A retrospective chart review was performed on 106 infants with a birthweight ≤6 kg receiving bedside PEG placement at Johns Hopkins All Children's Hospital between 2007 and 2013. Preprocedure, postprocedure, and demographic data were collected. The main safety outcome was postprocedure complication rate and the main efficacy outcome was time to initiate feeds and time on respiratory support.
The mean birth weight and mean gestational age of our population at the time of procedure were 2.2 kg and 33 weeks, respectively. There were 9 total complications (8.5%) with major complications being only 2 (1.8%). There were no instances of blood stream infections. The mean length of time to initiate feeds was 1.2 days (standard deviation [SD] = 1.2). Ninety-three percent of patients were extubated within 24 hours.
Bedside PEG placement is safe with minimal complications. It is associated with little need for ventilator support and allows for early re-initiation of feeds and early success at reaching goal feedings.
本研究旨在描述在三级新生儿重症监护病房（NICU）中行床边经皮内镜胃造口术（PEG）的安全性和有效性。
对 2007 年至 2013 年期间在约翰霍普金斯所有儿童医院接受床边 PEG 置管的 106 名出生体重≤6kg 的婴儿进行回顾性图表审查。收集了术前、术后和人口统计学数据。主要安全性结果是术后并发症发生率，主要疗效结果是开始喂养的时间和呼吸支持的时间。
我们人群的平均出生体重和平均胎龄分别为 2.2kg 和 33 周。共有 9 例总并发症（8.5%），其中仅 2 例为严重并发症（1.8%）。无血流感染的病例。开始喂养的平均时间为 1.2 天（标准差[SD]=1.2）。93%的患者在 24 小时内拔管。
床边 PEG 置管具有安全性，并发症少。它与呼吸机支持的需求低有关，并能及早重新开始喂养，及早达到目标喂养量。
