Percutaneous Endoscopic Gastrostomy

A Practical Overview on Its Indications, Placement Conditions, Management, and Nursing Care

Abstract

Percutaneous endoscopic gastrostomy (PEG) feeding represents the most effective and safest option for feeding patients with an impaired or diminished swallowing ability, despite having a functioning digestive system. The use of PEG has evolved to be useful in many situations beyond degenerative neuromuscular disorders, with an increasing body of evidence supporting the advantages of PEG tubes in oncologic and pediatric patients. Risk factors for complications after PEG tube placement include acute and chronic conditions associated with malnutrition and several organic disorders. Patients suitable for PEG tube placement should be individually identified to implement the advantages of this technique while minimizing risk events. The safety of placing a PEG tube in patients under antithrombotic medication has been investigated, as well as the advantages of antibiotic prophylaxis in reducing peristomal infection. Evidence supports the safety of early feeding after placement, thus resulting in lower costs. Percutaneous endoscopic gastrostomy-related complications are rare and mostly prevented by appropriate nursing care. Best medical practice and nursing care will ensure optimal performance leading to a wider acceptance, and greater utility of PEG by healthcare professionals, patients, and caregivers. This review aims to update knowledge relating to PEG tube indications, placement, management, and care in order to reinforce PEG feeding as the most valuable access for patients with a functional gastrointestinal system who have abnormalities in swallowing mechanisms.