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Nutrition in Clinical Practice
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Clinical Observations

DPEJ Tube Placement Prevents Aspiration Pneumonia in High-Risk Patients

Panagiotis H. Panagiotakis, MD
James A. DiSario, MD
Kristen Hilden, MS
Maydeen Ogara
John C. Fang, MD

From the Division of Gastroenterology and Hepatology, University of Utah Health Sciences Center, Salt Lake City, Utah.

Correspondence: Address correspondence to: John C. Fang, MD, Division of Gastroenterology and Hepatology, University of Utah, 4R118 School of Medicine, Salt Lake City, Utah 84132; e-mail: john.fang{at}hsc.utah.edu.

Percutaneous endoscopic gastrostomy (PEG) or PEG tube with transgastric jejunostomy tube (PEG-J) feeding has not been shown to decrease aspiration pneumonia. The aim of this study was to determine if direct percutaneous endoscopic jejunostomy (DPEJ) tube placement results in a decreased incidence of aspiration pneumonia in high-risk patients. The design was a retrospective review of all patients receiving DPEJ tube for aspiration pneumonia from 1999 to 2005. Demographics, incidence of aspiration pneumonia, and outcomes were collected and compared before and after the DPEJ placement. Eleven patients (4 women, 7 men) were identified; their mean age was 44.9 years (range, 18-94 years). The etiologies for recurrent aspiration pneumonia were neurologic disease (9), esophageal surgery (1), and severe debilitation (1). The mean follow-up was 20.9 months (range, 6-48 months). The patients' mean weight increased from 43.8 kg (range, 19-55 kg) to 48.3 kg (range, 30-65 kg) after placement (P < .001). The total number of documented aspiration pneumonia episodes for all patients decreased from 29 (mean, 3.64; range, 1-6) before DPEJ placement to 3 (mean, 0.27; range, 0-2) after DPEJ placement (P < .001). The mean number of aspiration pneumonia events per month prior to the DPEJ placement was 3.39 and postplacement was 0.42 (P < .001). DPEJ placement appears to decrease recurrent aspiration pneumonia in patients with history of aspiration pneumonia.

Key Words: enteral nutrition • enteral access • outcomes research/quality

Nutrition in Clinical Practice, Vol. 23, No. 2, 172-175 (2008)
DOI: 10.1177/0884533608314537
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