Efficacy of half-solid nutrient for the elderly patients with percutaneous endoscopic gastrostomy

Abstract

Percutaneous endoscopic gastrostomy tube feeding is widely used for patients with swallowing dysfunction and a history of repeated aspiration pneumonitis. However, liquid nutrient feeding via percutaneous endoscopic gastrostomy is not effective enough to prevent aspiration pneumonitis and related inflammatory responses. We performed this prospective multi-centre study to clarify the efficacy of half-solidification of nutrients to prevent fever possibly caused by aspiration pneumonitis in elderly patients with percutaneous endoscopic gastrostomy. The study subjects were 42 elderly patients undergoing percutaneous endoscopic gastrostomy feeding (mean age 85.8 years). All subjects were fed half-solid as well as liquid nutrients for 8 weeks respectively in a cross over design. We counted the number of days with fever caused by pneumonitis and unidentified origin. Thirty-two of 42 patients were successfully observed in both nutrient periods. Fever was frequently observed in both nutrient periods, however, the percentage of observational days with fever during half-solid nutrient feeding was significantly lower than that during liquid nutrient feeding (15.3 ± 0.3 vs 19.8 ± 0.4%, p = 0.030). The percentage of observational days when patients had diarrhea was not significantly different (10.1 ± 3.8 vs 7.2 ± 3.2%, p = 0.357). In conclusion, half-solid nutrient feeding was determined to be effective for reducing fever in patients with percutaneous endoscopic gastrostomy feeding.

Keywords: aspiration pneumonitis; half-solidification; nutrient; percutaneous endoscopic gastrostomy.

Figures

Fig. 1

Nutrient administration schedule (a: feeding schedule of half-solid nutrients, and b: feeding schedule of liquid nutrients).

Fig. 2

Time necessary for feeding care during half-solid nutrient feeding and that during liquid feeding.

Fig. 3

The percentage of observational days with fever (a), spontaneous defecation (b), and diarrhea (c) during half-solid nutrient feeding and during liquid nutrient feeding.