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Background: Percutaneous endoscopic gastrostomy (PEG) is considered the route of choice for long-term enteral nutrition. In this study, we evaluated the short term outcomes of PEG and aimed to identify the risk factors for in-hospital mortality as well as adverse events such as aspiration pneumonia., Methods: Three hundred and twenty-four patients who received PEG for enteral nutrition between January 2007 and December 2011 were included in this study. Data regarding baseline characteristics, preoperative biomarkers and clinical outcomes were collected and analyzed., Results: The average patient age was 82.3±10.9 (SD) years old. 149 patients (46%) were men and 199 patients (61%) had stroke as a comorbidity. Postoperatively, feeding-related aspiration pneumonia was observed in 72 patients (22%), diarrhea in 40 patients (12%) and peristomal infection in 34 patients (11%). The average postoperative length of stay was 34.6 days. 51 patients (16%) died before discharge, 22 (6.8%) of them within 30 days after PEG. Two deaths (0.6%) were considered procedure-related (bleeding). Multivariate analysis revealed the male gender, lower serum albumin levels and higher blood urea nitrogen (BUN) levels as significant prognostic factors for in-hospital mortality. Higher C-reactive protein levels and BUN levels were found to be independently associated with the occurrence of postoperative aspiration pneumonia., Conclusions: Our experience reconfirmed PEG as a minimally invasive and safe procedure for long-term enteral nutrition in patients with impaired oral intake. However, significant prognostic factors should be taken into account during the preoperative evaluation of patients. Deferral of procedure or specialized postoperative care may be indicated in high risk patients.

Background: Pasteurized donor milk is the recommended supplement for preterm infants when mother's milk volumes are insufficient. Compared with mother's milk, the macronutrient content of donor milk is thought to be lower due to pasteurization and additional container changes during processing. Given that poor growth is concerning for preterm infants, it is important to understand how processing and feeding methods influence the nutrition composition of donor milk feeds. The research aim of this study was to determine the effects of pasteurization and feeding method on the macronutrient and energy composition of donor milk. Ten donor milk pools were pasteurized, prepared according to neonatal practices, and infused through nasogastric tubes to simulate 4 feeding methods: bolus, 30 minutes, 60 minutes, and continuous feeding over 4 hours. Macronutrient concentrations were assessed after pasteurization, preparation, and each feeding method using a mid-infrared human milk analyzer., Results: There were no significant decreases in macronutrient content after pasteurization or bolus feeding. However, energy and fat losses increased with slower infusion rates. After continuous feeding for 4 hours, energy and fat concentrations decreased by a mean of 17.3 (15.8-18.8) kcal/dL and 2.08 (1.90-2.25) g/dL (P < .0001), respectively., Conclusions: Pasteurization did not significantly reduce donor milk macronutrient and energy content; however, feeding method significantly impacted the final delivery of energy and fat., (© 2018 American Society for Parenteral and Enteral Nutrition.)

For nutritional support of critically ill patients, the enteral route is preferred over the parenteral route. Although nasojejunal feeding can be superior to gastric feeding when gastrointestinal symptoms occur, it does not necessarily solve the problem of large gastric residual volumes. We report the successful use of a newly developed nasojejunal feeding tube with gastric decompression function in an 84-year-old man with severe pneumonia. After gastric feeding was considered not well tolerated, the use of this tube improved the delivery of nutrition until the patient was stable enough to undergo percutaneous endoscopic gastrostomy.