Percutaneous radiologic gastrostomy versus nasogastric tube in critically ill patients

Aims: To examine the feasibility of percutaneous radiologic gastrostomy in critically ill patients and to assess the rates of complications, esophagitis and gastroesophageal reflux when compared with nasogastric tube. Method: Sixty patients admitted to a medical intensive care unit and who were supposed to require gastric tubing for at least 14 days were randomized to have a nasogastric tube or a percutaneous radiologic gastrostomy. Patients with gastrostomy contraindication or gastric tubing for more than 2 days were excluded. Results: No major complication requiring invasive treatment was observed. The nasogastric tube was more prone to failure as defined by the impossibility to place or to replace the allocated tube (P=0.04) and to tube dysfunction (P<0.001), whereas gastrostomy was associated with increased incidence of minor local complications (P<0.001). Ten days after allocation, the rates of esophagitis (15%) and gastroesophageal reflux (24%) were not significantly different between the two groups. Conclusion: In selected critically ill patients, percutaneous radiologic gastrostomy carried a low risk of severe complication but we found no benefit in terms of esophagitis and gastroesphageal reflux between early performed gastrostomy and the nasogastric tube.