From the Guidelines
A Percutaneous Endoscopic Gastrostomy (PEG) tube can deliver various forms of liquid nutrition directly to the stomach, including commercial enteral formulas and blenderized whole foods, as well as water, medications, and supplemental fluids. The most commonly used formulas are polymeric, elemental, or semi-elemental, and disease-specific formulas, which provide 1-2 calories per milliliter and contain essential vitamins, minerals, and electrolytes 1. These formulas are suitable for patients with functioning digestive systems who cannot eat normally.
- Commercial enteral formulas, such as polymeric, elemental, or semi-elemental formulas, can be used to provide essential nutrients.
- Blenderized whole foods can also be given through a PEG tube, but must be thoroughly liquefied to prevent tube clogging.
- Water, medications, and supplemental fluids can also be administered through the tube.
- The nutrition plan should be individualized based on the patient's caloric needs, medical condition, and digestive capacity, as recommended by the ESPEN guidelines on artificial enteral nutrition--percutaneous endoscopic gastrostomy (PEG) 1. The ESPEN guidelines provide recommendations for the placement and care of PEG tubes, including the use of local anesthesia, sterile dressing, and regular cleaning and inspection of the wound site 1.
- Regular flushing of the tube with water is also recommended to prevent clogging and maintain tube patency.
- Patients and their relatives may need to be trained in the care of the tube and administration of feed or medication. Overall, PEG tube feeding allows for direct delivery of nutrition to the stomach, bypassing the mouth and esophagus, making it a suitable option for patients who cannot eat normally but have functioning digestive systems.
From the Research
Types of Nutrition Given Through a PEG Tube
The type of nutrition that can be given through a Percutaneous Endoscopic Gastrostomy (PEG) tube includes:
- Enteral nutrition, which aims to meet the nutritional requirements of patients who have an intact gastrointestinal (GI) tract but whose oral intake is inadequate 2
- Special diets and oral supplements, although their role becomes limited when oral intake is restricted or if swallowing is unsafe 3
- Nonrenal enteral formula, which may be useful for avoiding hypophosphatemia in patients with chronic hemodialysis 4
Administration of PEG Feeds
When administering a PEG feed, nurses should:
- Use a non-touch technique to reduce the risk of bacterial contamination 2
- Have the knowledge and skills required to administer enteral feeding via PEG safely and work within their level of competence 2
- Be able to recognize common complications of PEG feeding, such as hypophosphatemia 4 and exit site infections 4
Indications for PEG Feeding
PEG feeding is usually reserved for patients who have a functionally normal gastrointestinal tract, but who cannot meet their nutritional requirements due to inadequate oral intake, and is likely to be inadequate for more than 4-6 weeks 3. It is often recommended for patients who: