Demet TOK, Gülay OK, Koray ERBÜYÜN, Yasemin ERTAN, İsmail ÇETİN

Yoğun bakım ünitesinde perkutan endoskopik gastrostomi uygulamaları

Perkutan Endoskopik Gastrostomi (PEG) tekniği ilk tanımlandığı 1980’lerden buyana, kritik olgularda uzun süreli enteral beslemede uygun bir erişim yolu olarak kullanılmıştır. Bu çalışmada Anestezi Yoğun Bakım Ünitemizde izlenen hastalarda saptadığımız PEG komplikasyonlarının sunulması amaçlandı. Yatak başında “pull” tekniği ile PEG kanülü yerleştirilen 13 olgunun kayıtları incelendi. Tüm olgulara PEG tekniği sorunsuz uygulandı ve kanül başarı ile yerleştirildi. Gastrostomi tüplerinden beslenme süresi 13 ila 831 gün (ortalama 146 gün) olarak saptandı. 6 olgu PEG ile ilişkisi olmayan nedenlerden kaybedildi; 7 olgu PEG ile beslenmeye devam ederek taburcu edildi.4 olguda beslenme intoleransı ve bunların 3’ünde kanama gelişmesi dışında herhangi bir komplikasyonla karşılaşılmadı; bu sorunlar da uygun yaklaşımlarla tedavi edilebildi. Yoğun bakım ünitemizde karşılaştığımız en önemli PEG komplikasyonu kanamaydı.

Anahtar Kelimeler:

Ameliyat sonrası komplikasyonlar, Gastrostomi, Yoğun bakım üniteleri

Percutaneous endoscopic gastrostomy in intensive care unit

Since its introduction in the early 1980s, percutaneous endoscopic gastrostomy (PEG) technique has been used to create a reliable route for long term enteral feeding in cri0,0tically ill patients. Our goals were to determine the complications of PEG in ICU patients. We evaluated the data of 13 intensive care unit patients undergoing bedside PEG for gastric tube placement using the “pull” technique. Percutaneous endoscopic gastrostomy was completed and gastric tube was placed successfully in all patients. Tubes remained in stomach from 13 to 831 days (mean 146 days). Six patients died because of the reasons unrelated to the PEG tube and seven patients were discharged from the hospital while being fed via the PEG. Nutritional intolerance (in 4 patients) and bleeding (in 3 patients) were observed and could be eradicated by appropriate maintenance. Bleeding was the main PEG complication observed in critically ill patients.

Keywords:

Postoperative Complications, Gastrostomy, Intensive Care Units,

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