Morehouse School of Medicine, Department of Surgery, 720 Westview Drive SW, Atlanta, GA 30310, USA.
Emory School of Medicine, Department of Surgery, 69 Jesse Hill Jr. Dr. SE, 102, Atlanta, GA 30303, USA.
Injury. 2021 May;52(5):1198-1203. doi: 10.1016/j.injury.2021.03.002. Epub 2021 Mar 4.
Variation exists in the timing of tube feed initiation after percutaneous endoscopic gastrostomy (PEG) tube placement. The aim of our study was to review outcomes of early tube feed (ETF) versus late tube feed (LTF) initiation after PEG tube placement.
We performed a retrospective review of all trauma patients who underwent PEG tube placement from 1/2014 to 12/2018. ETF was defined as initiation < 24 h and LTF > 24 h after placement. The primary outcome measure was feeding intolerance and secondary outcomes included post-operative complications. All statistical analyses were performed using standard statistical methods (e.g. Pearson's Chi-squared, Fisher's exact and Mann Whitney-U tests).
There were 295 patients (164 ETF and 131 LTF) that received a PEG tube at our level 1 trauma center. There was no difference with feeding intolerance at 12 h (5% vs. 4%; p = 0.88), 24 h (1% vs. 2%; p = 1.00), and 48 h (4% vs. 4%; p = 1.00). There was no difference when comparing intolerance symptoms such as nausea and vomiting (1% vs. 2%; p = 0.79), abdominal tenderness (2% vs. 3%; p = 0.76), high gastric residuals (2% vs. 2%; p = 1.00) and aspiration (0% vs. 2%; p = 0.39). There was no difference when comparing post-operative complications (4% vs. 8%; p = 0.21).
Early tube feeding after PEG placement is safe and equivalent to late tube feeding in the adult trauma population. Future prospective studies are warranted to establish the optimal timing for initiation of tube feeds after PEG tube placement.
经皮内镜胃造口术（PEG）置管后开始管饲的时间存在差异。我们的研究目的是回顾 PEG 管放置后早期管饲（ETF）与晚期管饲（LTF）的结果。
我们对 2014 年 1 月至 2018 年 12 月期间接受 PEG 管放置的所有创伤患者进行了回顾性分析。ETF 定义为置管后<24 小时开始，LTF 定义为置管后>24 小时开始。主要观察指标为喂养不耐受，次要观察指标包括术后并发症。所有统计分析均采用标准统计方法（如 Pearson 卡方检验、Fisher 确切检验和 Mann-Whitney-U 检验）。
在我们的一级创伤中心，有 295 例患者（164 例 ETF 和 131 例 LTF）接受了 PEG 管。在 12 小时（5%比 4%；p=0.88）、24 小时（1%比 2%；p=1.00）和 48 小时（4%比 4%；p=1.00）时，不耐受的发生率没有差异。在比较不耐受症状（恶心和呕吐 1%比 2%；p=0.79）、腹痛（2%比 3%；p=0.76）、胃残留量高（2%比 2%；p=1.00）和吸入（0%比 2%；p=0.39）时，也没有差异。术后并发症的发生率也没有差异（4%比 8%；p=0.21）。
PEG 置管后早期管饲是安全的，在成年创伤患者中与晚期管饲等效。未来需要前瞻性研究来确定 PEG 管放置后开始管饲的最佳时机。
