PMID- 26209255
OWN - NLM
STAT- MEDLINE
DCOM- 20180118
LR  - 20180307
IS  - 1532-1983 (Electronic)
IS  - 0261-5614 (Linking)
VI  - 35
IP  - 4
DP  - 2016 Aug
TI  - Feasibility and results of pull-percutaneous endoscopic gastrostomy for enteral 
      nutrition in adults with severe cerebral palsy.
PG  - 918-23
LID - S0261-5614(15)00182-X [pii]
LID - 10.1016/j.clnu.2015.06.007 [doi]
AB  - BACKGROUND & AIMS: Eating and swallowing impairments often get worse as patients 
      with severe cerebral palsy (CP) get older, creating increased demand for 
      percutaneous endoscopic gastrostomy (PEG) tube placement. Here we investigated 
      the feasibility, safety, adverse events (AEs) and outcomes of PEG in adult CP. 
      METHODS: We performed a retrospective study of 26 consecutive severe adult (age: 
      28 [19-48] yrs) CP patients who underwent pull-PEG tube placement under general 
      anesthesia between 2005 and 2012 (median follow-up: 23 [6-64] months) at the same 
      tertiary hospital centre. RESULTS: The procedure was a technical success for 19 
      patients (BMI: 13.8 [10.7-21.4]) with (n = 11) or without (n = 8) previous 
      respiratory disorder. Indications were mainly swallowing disorders (n = 14) and 
      inadequate oral intake (n = 8). Early AEs were 7 transient oxygen needs, 3 local 
      wound infections and 2 transient ileus. Long-term AEs were 9 non-severe 
      gastrostomy incidents. There was no significant improvement in neurological 
      status but respiratory function was improved in 6 patients and enteral nutrition 
      enabled a significant median weight gain of 4.2 [1-8.8] kg (P < 0.01). 
      Quality-of-life assessed by relatives and the healthcare team was improved in 
      13/16 and 13/15 cases respectively. AEs and outcomes did not differ significantly 
      with previous respiratory disorder or nutritional status. CONCLUSIONS: PEG tube 
      placement is feasible in adult CP, although the risk of failure is increased by 
      anatomical specificities. Previous respiratory disorders and undernourishment did 
      not increase AE rates or modify outcomes. There were positive changes over time 
      for nutritional status and perceived quality-of-life, but no neurological 
      improvement.
CI  - Copyright (c) 2015 Elsevier Ltd and European Society for Clinical Nutrition and 
      Metabolism. All rights reserved.
FAU - Davout, Ariane
AU  - Davout A
AD  - Universite de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, equipe 
      Therapeutiques Innovantes et Technologies Appliquees aux Troubles Neuromoteurs, 
      UFR des Sciences de la Sante Simone Veil, Montigny-le-Bretonneux, France; 
      Departement de Medecine (Unite de Nutrition), Hopital Raymond Poincare, 
      Assistance Publique-Hopitaux de Paris, Garches, France.
FAU - Rech, Celia
AU  - Rech C
AD  - Medecine Physique et Readaptation, Hopital Raymond Poincare, Assistance 
      Publique-Hopitaux de Paris, Garches, France.
FAU - Hanachi, Mouna
AU  - Hanachi M
AD  - Universite de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, equipe 
      Therapeutiques Innovantes et Technologies Appliquees aux Troubles Neuromoteurs, 
      UFR des Sciences de la Sante Simone Veil, Montigny-le-Bretonneux, France; 
      Departement de Medecine (Unite de Nutrition), Hopital Raymond Poincare, 
      Assistance Publique-Hopitaux de Paris, Garches, France.
FAU - Barthod, Frederique
AU  - Barthod F
AD  - Departement de Medecine (Unite de Nutrition), Hopital Raymond Poincare, 
      Assistance Publique-Hopitaux de Paris, Garches, France.
FAU - Melchior, Jean Claude
AU  - Melchior JC
AD  - Universite de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, equipe 
      Therapeutiques Innovantes et Technologies Appliquees aux Troubles Neuromoteurs, 
      UFR des Sciences de la Sante Simone Veil, Montigny-le-Bretonneux, France; 
      Departement de Medecine (Unite de Nutrition), Hopital Raymond Poincare, 
      Assistance Publique-Hopitaux de Paris, Garches, France.
FAU - Crenn, Pascal
AU  - Crenn P
AD  - Universite de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, equipe 
      Therapeutiques Innovantes et Technologies Appliquees aux Troubles Neuromoteurs, 
      UFR des Sciences de la Sante Simone Veil, Montigny-le-Bretonneux, France; 
      Departement de Medecine (Unite de Nutrition), Hopital Raymond Poincare, 
      Assistance Publique-Hopitaux de Paris, Garches, France. Electronic address: 
      pascal.crenn@aphp.fr.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20150716
PL  - England
TA  - Clin Nutr
JT  - Clinical nutrition (Edinburgh, Scotland)
JID - 8309603
SB  - IM
MH  - Adult
MH  - Cerebral Palsy/*therapy
MH  - Deglutition Disorders/therapy
MH  - *Endoscopy, Gastrointestinal
MH  - Enteral Nutrition/*methods
MH  - Feasibility Studies
MH  - Female
MH  - Follow-Up Studies
MH  - *Gastrostomy
MH  - Humans
MH  - *Intubation, Gastrointestinal
MH  - Male
MH  - Middle Aged
MH  - Nutritional Status
MH  - Retrospective Studies
MH  - Tertiary Care Centers
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Cerebral palsy
OT  - Chronic disease
OT  - Enteral nutrition
OT  - Percutaneous endoscopic gastrostomy (PEG)
OT  - Swallowing disorders
OT  - Undernutrition
EDAT- 2015/07/26 06:00
MHDA- 2018/01/19 06:00
CRDT- 2015/07/26 06:00
PHST- 2015/03/11 00:00 [received]
PHST- 2015/06/05 00:00 [revised]
PHST- 2015/06/26 00:00 [accepted]
PHST- 2015/07/26 06:00 [entrez]
PHST- 2015/07/26 06:00 [pubmed]
PHST- 2018/01/19 06:00 [medline]
AID - S0261-5614(15)00182-X [pii]
AID - 10.1016/j.clnu.2015.06.007 [doi]
PST - ppublish
SO  - Clin Nutr. 2016 Aug;35(4):918-23. doi: 10.1016/j.clnu.2015.06.007. Epub 2015 Jul 
      16.