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Reasons of PEG failure to eliminate gastroesophageal reflux in mechanically ventilated patients

查看全文 作　　者：Emmanuel E [1]Douzinas;Ilias [1]Andrianakis;Olga [1]Livaditi;Dimitrios [1]Bakos;Katerina [1]Flevari;Nikos [2]Goutas;Dimitrios [2]Vlachodimitropoulos;Marios-Konstantinos [1]Tasoulis;Alex P [1]Betrosian 高影响力作者 机构地区：[1]3rd Department of Critical Care, Evgenidion Hospital,University of Athens Medical School, Athens 115 28,Greece;[2]The Laboratory of Pathology,Evgenidion Hospital,University of Athens Medical School,Athens 115 28,Greece高影响力机构 出　　处：《World Journal of Gastroenterology》索引2009年第15卷第43期,共6页高影响力期刊 摘　　要：AIM:To investigate factors predicting failure of percutaneous endoscopic gastrostomy(PEG)to eliminate gastroesophageal reflux(GER). METHODS:Twenty-nine consecutive mechanically ventilated patients were investigated.Patients were evaluated for GER by pH-metry pre-PEG and on the 7th post-PEG day.Endoscopic and histologic evidence of reflux esophagitis was also carried out.A beneficial response to PEG was considered when pH-metry on the 7th post-PEG day showed that GER was below 4%. RESULTS:Seventeen patients responded(RESP group)and 12 did not respond(N-RESP)to PEG.The mean age,sex,weight and APACHEⅡscore were similar in both groups.GER(%)values were similar in both groups at baseline,but were significantly reduced in the RESP group compared with the N-RESP group on the 7th post-PEG day[2.5(0.6-3.8)vs 8.1(7.4-9.2, P<0.001)].Reflux esophagitis and the gastroesophageal flap valve(GEFV)grading differed significantly between the two groups(P=0.031 and P=0.020, respectively).Histology revealed no significant differences between the two groups.CONCLUSION:Endoscopic grading of GEFV and the presence of severe reflux esophagitis are predisposing factors for failure of PEG to reduce GER in mechanically ventilated patients. 关 键 词：聚乙二醇 机械通气 食管 反流 患者 胃 储蓄计划 原因
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