Percutaneous endoscopic gastrostomy (PEG): Is it safe to begin feeding in three hours after insertion?

AIM: It is a common practice to delay initiation of PEG feeding for twenty four hours after placement of PEG tube to decrease the risk of complications. So we conducted a prospective study to determine whether initiation of feeding three hours after placement of percutaneous endoscopic gastrostomy (PEG) tube is safe. METHOD. Twenty consecutive patients requiring PEG in our hospital were randomized to two groups. A 20 - French Bard PEG was inserted, after obtaining informed consent and administration of intravenous antibiotics and sedation (if necessary). After PEG placement, patients in Group 1 (10 patients, Age 23-86) received feeding in three hours and patients in Group II (10 patients, Age 42-91) received feeding after 24 hours. Tube feeding was started at the rate of 30 cc/hr and advanced as appropriate for each patient. Feeding residuals were checked every eight hours with the intention to hold feeding if the residuals were more than 100 cc. Twenty four hours after initiation of feeding, all patients were evaluated for the presence of fever, abdominal distention, residuals greater than 100 cc and any leakage, discharge or bleeding at the wound site. RESULTS: None of the patients m either Group I or Group II had fever, abdominal distention, increased residuals or peri-stomal complications. CONCLUSION: PEG tube feeding three hours after placement is safe.