ABSTRACT
OBJECTIVE: To determine the effect of immediate vs. next-day feeding after percutaneous endoscopic gastrostomy in intensive care and intermediate care patients. DESIGN AND SETTING: A prospective, randomized, controlled trial of the clinical outcome in two German hospitals. PATIENTS: The study included 80 patients: 40 in group 1 who received enteral feeding within 1 h and 40 in group 2 in whom feeding was started 24 h after percutaneous endoscopic gastrostomy feeding. INTERVENTIONS: Patients were fed a polymeric iso-osmolar formula via pump 30 ml/h in 20 h on day 1, 70 on day 2, and l00 on day 3. Every 6 h for 72 h gastric residue was checked, and the patient was examined by a physician the first 3 days. MEASUREMENTS AND RESULTS: Comparing the maximum residual volumes for each group for each day as the major end-points, the immediate feeding group showed an increase of about 20-50% on each day, which, however, was significant only on day 2. Our study also failed to show any significant difference in complication rate or either short-term (1-3 days) or long-term (1-30 days) mortality. CONCLUSIONS: In acutely ill intensive and intermediate care patients immediate enteral feeding via a percutaneous endoscopic gastrostomy tube is as safe as next-day feeding.
Subject(s)
Endoscopy/methods , Enteral Nutrition/methods , Gastrostomy/methods , Aged , Chi-Square Distribution , Female , Humans , Male , Middle Aged , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
Cyclic vomiting syndrome is an unusual cause of recurrent episodes of repetitive vomiting, particularly in children. Although in only a minority of cases can an underlying cause be found, each patient deserves a thorough evaluation for treatable conditions. We present four cases of cyclic vomiting syndrome caused by ureteropelvic obstruction. Surgical correction was followed by resolution of symptoms in all four patients.
