title: A randomized prospective trial of immediate vs. next-day feeding after percutaneous endoscopic gastrostomy in intensive care patients.
abstract: OBJECTIVE
  To determine the effect of immediate vs. next-day feeding after percutaneous endoscopic gastrostomy in intensive care and intermediate care patients.
  
  
  METHODS
  A prospective, randomized, controlled trial of the clinical outcome in two German hospitals.
  
  
  METHODS
  The study included 80 patients: 40 in group 1 who received enteral feeding within 1 h and 40 in group 2 in whom feeding was started 24 h after percutaneous endoscopic gastrostomy feeding.
  
  
  METHODS
  Patients were fed a polymeric iso-osmolar formula via pump 30 ml/h in 20 h on day 1, 70 on day 2, and l00 on day 3. Every 6 h for 72 h gastric residue was checked, and the patient was examined by a physician the first 3 days.
  
  
  RESULTS
  Comparing the maximum residual volumes for each group for each day as the major end-points, the immediate feeding group showed an increase of about 20-50% on each day, which, however, was significant only on day 2. Our study also failed to show any significant difference in complication rate or either short-term (1-3 days) or long-term (1-30 days) mortality.
  
  
  CONCLUSIONS
  In acutely ill intensive and intermediate care patients immediate enteral feeding via a percutaneous endoscopic gastrostomy tube is as safe as next-day feeding.
authors.affiliation: Medizinische Klinik II, Johann-Wolfgang-Goethe Universität, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. j.stein@em.uni-frankfurt.de
authors.forename: Jurgen
authors.initials: J
authors.lastname: Stein
authors.forename: Arnd
authors.initials: A
authors.lastname: Schulte-Bockholt
authors.forename: Marion
authors.initials: M
authors.lastname: Sabin
authors.forename: Michael
authors.initials: M
authors.lastname: Keymling
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D004724:Endoscopy / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome