Nutritional status improvement in neurologically impaired patients by percutaneous endoscopic gastrostomy feeding

RESUMO

With increased use of percutaneous endoscopic gastrostomy, it became clear that neurologically impaired patients might benefit from its use. From August 1996 to july 1997, we performed 19 percutaneous endoscopic gastrotomies in patients with neurological sequelae, who were incapable to maintain their nutritional status by oral ingestion or had repeated episodes of aspiration. Sixteen patients were followed prospectively, from 30 days to 11 months (median: 6,4 months). Average weight (38.2 Kg to 44,8 Kg), BMI (14.8 kg/m2 to 17.8 Kg/m2), weight/height ratio (23.5 Kg/cm to 28 Kg/cm), mid-upper arm circumference (19.4 cm to 21.6 cm) and triceps skinfold thickness (10.3 mm to 12.6 mm) were significantly increased (P<0.01). Before percutaneous endoscopic gastromoty, there were 10 (10/16, 62.5 per cent) patients with grade III thinness. In this group, 3/10 patients (30 per cent) showed improvement to grade I (two individuals) and II (one patient). All but five patients (68.75 per cent) were below the fifth percentile of normal distribution for mid-upper arm circuference. One patient (6.2 per cent) showed improvement of her status (between 25 th and 50 th percentiles). Four patients (25 per cent) started the follow-up below the fifth percentile for normal distribution of triceps skinfold thickness, and showed no improvement. There were no early complications secondary the procedure. Late complications included granulation tissue on ostomy site (18.8 per cent) and ostomy infection (6.2 per cent). Statistical analysis showed significant improvement of anthropometric data. Percutaneous endoscopic gastrostomy is a simple, highly succesful and safe procedure, when performed in neurologically impaired patients. It is efficient as a long-term enteral feeding method.