Intensivists can now place PEG tubes (PUGs, actually)
New ultrasound-guided approach could reduce ICU stays
When a ventilator-dependent patient survives their acute illness but will be dependent on hospital care for weeks or months, they often need a tracheostomy and a percutaneous gastrostomy tube before discharge to a long-term acute care hospital (LTACH). Achieving the placement of these two small plastic tubes into the body, generally requiring two different surgical/procedural specialists, commonly prolongs ICU stays by several days.
Intensivists have been performing an increasing share of tracheostomies, as more have gained proficiency in bedside percutaneous dilational tracheostomy (“perc trach”) during training or in practice. Perc trachs do not require operating room time or a surgeon, and can significantly shorten ICU stays.
Now, a few intensivists are going for the gut, with a new bedside ultrasound-guided Seldinger-style procedure that could displace percutaneous endoscopic gastrostomy tubes (PEGs) placed by gastroenterologists or interventional radiologists.
Percutaneous Ultras…
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