Gastrostomy Report

8/13/2019 Gastrostomy Report

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Advantages of Gastrostomy

less time spent giving feeding

feeding can be done at night when child is

sleep

easily administered

provides an alternative route of feeding and

drug administration

decreases the risk of pulmonary aspiration

sure way of administering formula directly into the stomach

Disadvantages of Gastrostomy

leakage

risk of infection skin irritation

gastric distention

bleeding

Types of Gastrostomy

1. Stamm (Temporary and Permanent )

require either an upper abdominalmidline incision or a left upper quadranttransverse incision

requires the use of concentric pursestring sutures to secure a tube to theanterior gastric wall

an exit wound is created in the leftabdominal midline incision or a left upperabdomen to provide for the gastrostomy.

2. Janeway (Permanent)

require the same as stamm an upperabdominal midline incision or a left upperquadrant transverse incision


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necessitates the creation of a tunnel (called a gastric tube) that is brought outthrough the abdomen to form a permanent stoma

3. Percutaneous Endoscopic Gastostomy

is a procedure that requires the series oftwo physicians (or a physician and aspecially trained nurse)

the initial PEG device can be removedand replaced once the tract is wellestablished (1014 days afterinsertion)

4. LowProfile Gastrostomy Device (PGD)

may be inserted 36 months after initialgastrostomy tube placement

these devices are inserted flush with theskin; they eliminate the possibility of tubemigration and obstruction and haveantireflux valves to prevent gastric flux

Two types of devices may be used:

Obturated Devices (PEGButton orGastroPart II)

have done tip that acts as aninterval stabilizer

Nonobturated Devices (MIC - KEY)

has an external skin disk and isinserted into the stoma withoutforce; a balloon is inflated to secure placement

Types of Tube Feeding Methods

1. Bolus Tube Feedings

Allow introduction of 250 to 400 ml formula through the tube in a short period(usually 1530 minutes)

Administered by syringe or gravity flow system attached to the distal end of thefeeding tube


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2. Intermittent Tube Feeding

Allow delivery of between 250 and 400 ml formula are 306- minutes

Delivered by gravity flow system or an electric feeding pump

3. Continuous Tube Feeding

Allow formula to be administered at low ratesusually 1.5ml/min over a longertime (usually 1224 hours)

Delivered by gravity flow system or an electronic feeding

4. Cyclic Tube Feeding

Allow formula to be administered at lower ratesusually 1.5 ml/min over a longertime (usually 1224 hours)

Ensure adequate nutrition during weaning from tube to oral feeding

Alternate with oral food intake until client can take most nutrition orally

Types of Feeding Formula

1. Blenderized Formula

used infrequently, are more likely to clog feeding tube since they have a highviscosity

2. Commercially Prepared Polymeric Formula

contain unaltered molecules of proteins, carbohydrates and fats. They arebest for people who can digest and absorb nutrients without difficulty

are available as standard formulations containing protein isolate with one ormore sources of carbohydrates and fats.

3. Modular Formula is an incomplete liquid supplement that contains specific nutrients usually

single macronutrient.

4. Chemically Defined Formula

represent the ultimate reduction of food and have been called Space Diets

5. Disease Specific Formula

available to meet the needs of patients with specific medical problems, suchas glucose intolerance, liver disease, ling disease, GI dysfunction, renaldisease, etc.

Documents

Gastrostomy Report