PEG (Percutaneous Endoscopic Gastrostomy) Tube Complications in ICU: What Families in Intensive Care Need to Know and Safer Alternatives! Quick Tip for Families in ICU!

“PEG Tube Complications in ICU: What families in intensive care need to know and safer alternatives.”

My name is Patrik Hutzel from intensivecarehotline.com, where we help families of critically ill patients in intensive care to improve their lives instantly so that you can make informed decisions, have peace of mind, real power, real control. And so that you can influence decision making fast, so that your loved one always gets best care and treatment, even if you’re not a doctor or a nurse in intensive care.

If you’re worried about the loved one in intensive care with a PEG tube, complications, and abscess, and now, kidney failure needing dialysis, this is for you.

So, today’s question comes from Heather, who writes.

Hi, Patrik,
I have a question. My daughter’s PEG (Percutaneous Endoscopic Gastrostomy) tube in ICU was dislodged and caused an abscess. They had to operate her yesterday to remove it and clean it up as well as repair the stomach rupture. Now, this has caused her kidneys to suffer, and they want to do dialysis. I am so worried. What are the best things to do here? Thank you from Heather.”

Heather, I’m very sorry to hear what’s happening with your daughter. Unfortunately, complications from PEG tubes, also known as percutaneous endoscopic gastrostomy tubes, are not uncommon in ICU. When a peg tube gets dislodged, it can cause infections, abscesses. And even stomach perforations that require urgent or emergency surgery, just like in your daughter’s situation.

Now you’re telling me her kidneys are suffering and doctors are suggesting. Dialysis, and this is not surprising to me after major surgery. Sepsis, which is an infection in the bloodstream, and abdominal complications, the body can go into shock, and the kidneys are often the first organs to shut down.

Dialysis in ICU is often life-saving and support the kidney function temporarily until your body, until your daughter’s body can recover.

But here is what you need to know. If you had come to me a few weeks ago and he would have said, should I give consent to a peg tube, I would have said absolutely not. Absolutely not, because an nasogastric tube and G-tube (gastrostomy tube) is often a safer, less invasive alternative than a PEG tube. Especially in the early stages of critical illness in ICU.

A nasogastric tube can provide nutrition without the risk of a surgical procedure, like a PEG placement. Many ICUs rush into PEG tubes prematurely, when a simple nasogastric tube would have sufficed and especially for our audience in the US, if you give consent to a tracheostomy and the peg tube, it’s much more likely that your loved one will go to an LTAC (Long Term Acute Care).

Now both tracheostomy and PEG tubes have that time in their place, but you need to know when they have that time in their place. Certainly not after just a few weeks in ICU and nasogastric tube will do perfectly fine.

Next, kidney failure after complications is not the end. Dialysis can often be a bridge to recovery. Many patients in ICU need to temporary dialysis and then regain kidney function once the infection and overall condition improve.

Next, ask the ICU team about the plan. Is dialysis-intended short term to support her through this crisis? What are the chances of her kidneys recovering? What are the markers they’re monitoring, such as urine output, creatinine, bond levels, electrolytes, etc.

Next, advocate for less invasive options going forward. If your daughter needs ongoing nutrition and feeding support, push for a nasogastric tube rather than rushing back to another PEG placement. The peg should only be conceived that if it’s clear, she cannot swallow for months or even years on end, and only when she’s stable enough for such a procedure.

Also, in certain situations, you also need to think about, if they’re rushing towards a PEG tube, is it simply because the surgeons want to operate and the hospital wants to make some money. And as the gastric tube is much quicker, it’s much safer, and much less invasive.

Heather, the best thing you can do right now is to stay calm, ask the ICU team the right questions and make sure they are transparent with you about next steps, risks, and alternatives. Your daughter is in a very delicate situation, but dialysis can help her stabilize.

Now, if you need 1-to-1 support to navigate this situation with the ICU team, if you want to know, should your loved one have a PEG tube? Should they have a tracheostomy, we can advise you independently because we look at medical records, talk to doctors and nurses directly with you. Advocate for your daughter and make sure you get the best care and treatment always and get all the answers.

I have worked in critical care nursing for 25 years in three different countries, where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

The biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on the show. You will get notification for the YouTube live if you are a subscriber to my YouTube channel or my intensivecarehotline.com email newsletter at intensivecarehotline.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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