Nursing care of patients with PEG

Perkutana endoskopska gastrostoma (PEG) je procedura umetanja sonde (cijevi) kroz trbušni zid u lumen želuca pod kontrolom gastroskopa u svrhu direktnog davanja hrane i tekućine u želudac u slučajevima kada pacijent ne može, odnosno ne smije jesti i piti na usta. Može se primijeniti kod bolesnika (odraslih i djece) kojima je nepovrijeđen i funkcionalno uredan gastrointestinalni sustav, imaju potrebu za pojačanom ili dugotrajnom enteralnom prehranom, a nisu u mogućnosti putem usta unijeti kalorijski dovoljno hrane za metaboličke potrebe. Indikaciju predstavljaju oni slučajevi kod kojih je zbog opstrukcije gornjeg dišnog ili gastrointestinalnog sustava, hranjenje NGS otežano ponavljajućim aspiracijama ili kada bolesnik sondu ne može podnositi zbog lokalnih razloga. Najčešće se koristi kod bolesnika sa cerebrovaskularnim bolestima, orofaringealnim malignitetima i motornim neuronskim bolestima. PEG je sigurna, efikasna i tehnički relativno jednostavna metoda sa vrlo malim brojem komplikacija, te vrlo dobrog poboljšanja nutritivnog statusa bolesnika. Velika je prednost perkutane sonde što može biti funkcionalna otprilike godinu dana i duže. Metoda perkutane endoskopske gastrostome - PEG prvi je puta opisana 1980. godine od Gauderera kao alternativa kirurškoj gastrostomi, posebno kod bolesnika s velikim rizikom od kirurških zahvata. Nakon ugradnje PEG-a bolesnik mora mijenjati stare životne navike, naročito u vezi prehrane, te se mora prilagođavati na nove. Pacijentu je potrebna stručna pomoć oko načina prehrane, toaleti, te komplikacijama, a tu veliku ulogu ima medicinska sestra.Percutaneous endoscopic gastrostomy (PEG) is the procedure of inserting the probe (tube) through the abdominal wall into the lumen of the stomach under control gastroscope for the purpose of directly providing food and liquids into the stomach in cases where the patient can not or should not eat or drink by mouth. It can be applied in patients (adults and children) which have unscathed and functionally normal gastrointestinal system, the need for increased or prolonged enteral treatment, and are not able to take in calorically enough food for metabolic needs through the mouth. Indication represent cases in which, due to obstruction of the upper respiratory or gastrointestinal system, feeding NGS is difficult because repeating aspirations or when the patient can not tolerate the probe due to local reasons. It is commonly used in patients with cerebrovascular disease, oropharyngeal malignancy and motor neuron disease. PEG is a safe, effective and technically relatively simple method with very few complications, and very good improvement of the nutritional status of patients. A great advantage of percutaneous probes is that it can be functional for about a year or longer. The method of percutaneous endoscopic gastrostomy - PEG was first described in 1980 by Gauderera as an alternative to surgical gastrostomy, especially in patients with a high risk of surgical procedures. After installing the PEG patient must change old habits, especially regarding diet, and must adapt to the new. The patient is in need of professional help with diet, toilets, and complications, and the nurse has important role in it