Decreased Frequency of Aspiration Pneumonia after Percutaneous Endoscopic Gastrostomy in Neurodisabled Children with Dysphagia / 대한소아신경학회지

ABSTRACT

PURPOSE: Nasogastric tube or percutaneous endoscopic gastrostomy (PEG) tube can provide a means of feeding when oral intake is not adequate. This study aimed to evaluate the benefits of PEG such as reduced respiratory complications in neurodisabled children with dysphagia. METHODS: Twenty-six neurodisabled patients with dysphagia were followed-up after PEG for at least 12 months from 1999 to 2008. Medical records including characteristics, body weight, frequency of aspiration pneumonia, and grade of gastroesophageal reflux (GER) were reviewed retrospectively between the time before and after PEG. The data collected before PEG was compared with those at 0-6 months and 6-12 months after PEG. RESULTS: The 26 (male 14) enrolled patients had a mean age on PEG of 6.4+/-4.7 (0.9-16.9) years. The body weight percentile of 16 out of 26 patients was under the 3rd percentile. Underlying diseases were cerebral palsy (n=16), acquired brain-injury (n=4), spinal muscular atrophy (n=3), neurodegenerative disease (n=2), and congenital muscular dystrophy (n=1). Body weight was not significantly different before and after PEG. The frequency of aspiration pneumonia was 2.2 times per 6 months before PEG, compared to 0.35 times (0-6 months) and 0.27 times (6-12 months) after PEG, which showed a significant difference (P=0.000). CONCLUSION: The frequency of aspiration pneumonia decreased significantly by PEG in neurodisabled children with dysphagia.