High Level of Intra-Gastric Pressure is Risk Factor for Patients with Percutaneous Endoscopic Gastrostomy (PEG)

In Japan, percutaneous endoscopic gastrostomy (PEG) has been used mainly in patients with stroke and dementia, who are unable to undertake oral ingestion voluntarily. The number of patients who rely on PEG feeding has recently increasing. The occurrence of aspiration pneumonia after PEG placement is difficult to predict. With a simple and new examination procedure which measures intra-gastric pressure (IGP) during the hungry period, we were able to determine the presence of aspiration pneumonia in PEG patients. Sixty patients living in a home-care type facility or nursing home were examined in our hospital from November, 2010 to January 2011. The patient lies down horizontally in the supine position. IGP is measured using a PEG tube. Using like this method, the intraabdominal pressure (IAP) is measured in cases of the abdominal compartment syndrome, while central venous pressure (CVP) is measured in cases of heart disorder. The mean IGP in patients without complicated pneumonia was 2.1 ± 1.7 cmH2O. In patients with complicated pneumonia (p<0.0001), it was 7.9 ± 2.7 cm H2O. There is a relationship between IGP and the symptoms of aspiration pneumonia. Our simple and easy technique can estimate the level of complication and can assist in the prevention of pneumonia in patients living in nursing facilities.