Efficacy of continuous suction in the hypopharynx during percutaneous endoscopic gastrostomy : a prospective study of prevention of aspiration

Abstract

Background : Aspiration pneumonia may be a fatal postoperative complication of percutaneous endoscopic gastrostomy (PEG) . We evaluated the efficacy of a method involving continuous suction in the hypopharynx in preventing aspiration.
Patients and Methods : Patients requiring PEG were randomly assigned to a group in which continuous suction was performed in the hypopharynx (continuous suction group) or a group in which manual suction was frequently performed in the oral cavity and pharynx (manual suction group) . For the continuous suction, a suction catheter was inserted via the nostril, with its tip in the hypopharynx, to continuously suction saliva during PEG. From findings on chest computed tomography (CT) performed the next day, the clinical incidence of aspiration pneumonia and the volume of the suctioned contents were assessed.
Results : Thirty patients were assigned to each group. New CT findings were significantly less frequent in the continuous suction than in the manual suction group (0% vs. 33%, P ＜ 0.001) , with all the new findings likely resulting from aspiration. The rate of clinical aspiration pneumonia in the two groups was similar (0% vs. 7%, P = 0.25) , whereas the median volume suctioned was significantly greater in the continuous suction group (2 ml vs. 0 ml ; P = 0.02) .
Conclusions : Continuous suction in the hypopharynx during PEG is useful for preventing aspiration.