@article{3143939,
    title = "Reasons of PEG failure to eliminate gastroesophageal reflux in
mechanically ventilated patients",
    author = "Douzinas, Emmanuel E. and Andrianakis, Ilias and Livaditi, Olga and and Bakos, Dimitrios and Flevari, Katerina and Goutas, Nikos and and Vlachodimitropoulos, Dimitrios and Tasoulis, Marios-Konstantinos and and Betrosian, Alex P.",
    journal = "World Journal of Gastroenterology",
    year = "2009",
    volume = "15",
    number = "43",
    pages = "5455-5460",
    publisher = "BAISHIDENG PUBLISHING GROUP INC",
    issn = "1007-9327",
    doi = "10.3748/wjg.15.5455",
    keywords = "Esophagitis; Gastroesophageal reflux; Percutaneous endoscopic
gastrostomy",
    abstract = "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 APACHE H score
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. (C) 2009 The WIG Press and Baishideng.
All rights reserved."
}