Document Detail

Safety and feasibility of interventional pulmonologists performing bedside percutaneous endoscopic gastrostomy tube placement.
MedLine Citation:
PMID:  23392239     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Prior to the 1980s, permanent feeding tube placement was limited to an open surgical procedure until Gauderer and colleagues described the safe placement of percutaneous endoscopic gastrostomy (PEG) tubes. This procedure has since expanded beyond the realm of surgeons to include gastroenterologists, thoracic surgeons, and interventional radiologists. In some academic centers, interventional pulmonologists (IPs) also perform this procedure. We describe the safety and feasibility of PEG tube placement by IPs in a critically ill population.
METHODS: Prospectively collected data of patients in a medical ICU undergoing PEG tube placement from 2003 to 2007 at a tertiary-care center were reviewed. Inclusion criteria included all PEG tube insertions performed or attempted by the IP team. Data were collected on mortality, PEG tube removal rate, total number of days with PEG tube, and complication rates. Follow-up included hospital length of stay and phone contact after discharge. Procedural and long-term PEG-related complications were recorded.
RESULTS: Seventy-two patients were studied. PEG tube insertion was completed successfully in 70 (97.2%), with follow-up data in 69 of these 70. Thirty-day mortality was 11.7%. No deaths or immediate complications were attributed to PEG tube placement. PEG tube removal occurred in 27 patients, with a median time to removal of 76 days.
CONCLUSIONS: Bedside PEG tube placement can be performed safely and effectively by trained IPs. Because percutaneous tracheostomy is currently performed by IPs, the ability to place both PEG and tracheostomy tubes at the same time has the potential for decreased costs, anesthesia exposure, procedural times, ventilator times, and ICU days.
Lonny Yarmus; Christopher Gilbert; Noah Lechtzin; Melhem Imad; Armin Ernst; David Feller-Kopman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  144     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-08-06     Completed Date:  2014-01-09     Revised Date:  2014-03-20    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  436-40     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Critical Illness*
Device Removal
Endoscopy, Gastrointestinal* / adverse effects
Feasibility Studies
Gastrostomy / adverse effects,  methods*
Hospital Mortality
Intensive Care Units
Length of Stay / statistics & numerical data
Middle Aged
Patient Safety
Prospective Studies
Pulmonary Medicine*
Time Factors
Treatment Outcome
Comment In:
Chest. 2013 Aug;144(2):368-9   [PMID:  23918099 ]
Chest. 2014 Feb;145(2):421-2   [PMID:  24493530 ]
Chest. 2014 Feb;145(2):422-3   [PMID:  24493531 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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