Physician opinions on decision making for percutaneous endoscopic gastrostomy (PEG) feeding tube placement.

Background: Percutaneous endoscopically placed gastrostomy (PEG) tubes are useful for long-term enteral nutrition; however, they are associated with lack of benefit for patients with advanced dementia, at end of life, and for some stroke patients with early regain of swallowing function. We surveyed physician opinions on decision making with the aim to identify factors that can lead to inappropriate PEG placement, as a first step of a quality improvement initiative to prevent inappropriate PEG placements at our facility.

Methods: A survey was distributed to 231 physicians, with questions about discussion topics, contraindications, responsibilities, and practices in decision making for PEG placement.

A Call to Action to Bring Safer Parenteral Micronutrient Products to the U.S. Market.

The American Society for Parenteral and Enteral Nutrition (A.S.P.

Trace elements in parenteral nutrition: a practical guide for dosage and monitoring for adult patients.

Parenteral nutrition (PN) is a life-sustaining therapy for hundreds of thousands of people who have severe impairment of gastrointestinal function. Trace elements are a small but very important part of PN that can be overlooked during busy practice. Serious complications can result from trace element deficiencies and toxicities, and this is especially problematic during times of product shortages.

A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products.

The parenteral multivitamin preparations that are commercially available in the United States (U.S.) meet the requirements for most patients who receive parenteral nutrition (PN).

No difference in catheter sepsis between standard and antiseptic central venous catheters. A prospective randomized trial.

Objective: To determine the efficacy of antiseptic compared with standard triple lumen central venous catheters (CVCs) in reducing the incidence of catheter sepsis and catheter site infection in patients with CVCs for total parenteral nutrition.

Design: A prospective, randomized, controlled trial.

Setting: Truman Medical Center, the public teaching hospital for University of Missouri, Kansas City, School of Medicine.