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Percutaneous Ultrasound Guided Gastrostomy Tube Placement: A Prospective Cohort Trial.
Reis, Stephen P; Brejt, Sidney Z; Weintraub, Joseph R; Ahmad, Noor; Susman, Jonathan; Mobley, David G.
  • Reis SP; Division of Interventional Radiology, Columbia University Irving Medical Center, New York, NY, USA.
  • Brejt SZ; Division of Interventional Radiology, Columbia University Irving Medical Center, New York, NY, USA.
  • Weintraub JR; Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA.
  • Ahmad N; Division of Interventional Radiology, Columbia University Irving Medical Center, New York, NY, USA.
  • Susman J; Division of Interventional Radiology, Columbia University Irving Medical Center, New York, NY, USA.
  • Mobley DG; Division of Interventional Radiology, Columbia University Irving Medical Center, New York, NY, USA.
J Intensive Care Med ; 37(5): 641-646, 2022 May.
Article in English | MEDLINE | ID: covidwho-1218276
ABSTRACT

BACKGROUND:

To compare the safety and efficacy of percutaneous ultrasound guided gastrostomy (PUG) tube placement with traditional fluoroscopic guided percutaneous gastrostomy tube placement (PRG).

METHODS:

A prospective, observational, non-randomized cohort trial was performed comparing 25 consecutive patients who underwent PUG placement between April 2020 and August 2020 with 25 consecutive patients who underwent PRG placement between February 2020 and March 2020. Procedure time, sedation, analgesia requirements, and complications were compared between the two groups in non-inferiority analysis.

RESULTS:

Technical success rates were 96% in both groups (24/25) of procedures. Ninety-two percent of patients in the PUG cohort were admitted to the ICU at the time of G-tube request. Aside from significantly more COVID-19 patients in the PUG group (P < .001), there was no other statistically significant difference in patient demographics. Intra-procedure pain medication requirements were the same for both groups, 50 micrograms of IV fentanyl (P = 1.0). Intra-procedure sedation with IV midazolam was insignificantly higher in the PUG group 1.12 mg vs 0.8 mg (P = .355). Procedure time trended toward statistical significance (P = .076), with PRG being shorter than PUG (30.5 ± 14.1 minutes vs 39.7 ± 17.9 minutes). There were 2 non-device related major complications in the PUG group and 1 major and 1 minor complication in the PRG group.

CONCLUSION:

PUG is similar in terms of complications to PRG gastrostomy tube placement and a safe method for gastrostomy tube placement in the critically ill with the added benefits of bedside placement, elimination of radiation exposure, and expanded and improved access to care.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrostomy / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Intensive Care Med Journal subject: Critical Care Year: 2022 Document Type: Article Affiliation country: 08850666211015595

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrostomy / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Intensive Care Med Journal subject: Critical Care Year: 2022 Document Type: Article Affiliation country: 08850666211015595