Pharmacology Book

Analgesic Medications

Nutrition

  • Enteral Tube Feeding

http://www.fpnotebook.com/

Enteral Tube FeedingAka: Percutaneous Endoscopic Gastrostomy Tube, PEG Tube

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  1. Indications
    1. Nutrition in Advanced Dementia
      1. See link for details regarding lack of efficacy
      2. No support for continued use in the literature
  2. Complications: General
    1. Tube malfunction, obstruction or migration
    2. Aspiration
    3. Nausea, Vomiting and Diarrhea
    4. Gastrointestinal Bleeding
    5. Bowel Obstruction
    6. Provocation of Gastroesophageal Reflux
    7. Increased skin moisture and maceration
    8. Agitation with a greater need for restraints
  3. Complications: Nasogastric Tube
    1. Trauma and bleeding from nasopharynx and esophagus
    2. Post-cricoid perichondritis
    3. Misdirected tube into lung or brain
    4. Self-extubation common
    5. Otitis Media
    6. Sinusitis
    7. Tracheoesophageal fistula
    8. Pneumothorax
    9. Pneumonitis
    10. Lung Abscess
    11. Tracheobronchial perforation
    12. Infusion into lung
    13. Airway obstruction
    14. Esophageal or duodenal perforation
    15. Esophageal Stricture
    16. Increased secretions and need for suctioning
    17. Increased need for repositioning
  4. Complications: Gastrostomy or Jejunostomy
    1. Tube insertion site trauma
      1. Inflammation and bleeding
      2. Bumper erodes into abdominal wall
    2. Stoma closure or stenosis
    3. Tube erodes into pleura
    4. Gastric perforation
    5. Gastric prolapse
    6. Gastrocolic fistula
    7. Pneumoperitoneum
    8. Evisceration
    9. Intussusception
    10. Peritonitis
    11. Cellulitis
    12. Abdominal abscess
    13. Arrhythmia
    14. Mediastinitis
  5. References
    1. Finucane (1999) JAMA 282:1368
    2. Li (2002) Am Fam Physician 65(8):1605

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