Comparative Outcomes of PEG Patients With and Without Hypoxia: Laboratory Findings, Gastric Biopsy Results and Procedural Sedation Practices

İngilizce (OpenAlex)

Objective: This study aimed to compare laboratory findings, sedation practices, and endoscopic gastric biopsy results in critically ill patients undergoing percutaneous endoscopic gastrostomy (PEG), with a particular focus on the presence or absence of tissue hypoxia. Material and Methods: A total of 92 intubated patients (>18 years) who underwent PEG in a tertiary intensive care unit were evaluated. Of these, 46 patients exhibited tissue hypoxia (PaO₂ < 60 mmHg and sPO₂ < 89%) and aspiration pneumonia, while the remaining 46 patients, without tissue hypoxia, served as controls. Data collection included demographic characteristics, laboratory parameters, sedation agent use (midazolam and propofol), and endoscopic gastric biopsy findings (Helicobacter pylori, atrophy, and metaplasia). These variables were systematically analyzed and compared between the two groups to identify significant differences. Results: Patients with and without tissue hypoxia had similar age and gender distributions. However, significant differences were observed in laboratory parameters, including albumin, hemoglobin, platelet count, TSH, and PT (p<0.05). Patients with tissue hypoxia had higher platelet and TSH levels, while those in the control group had higher albumin, hemoglobin, and PT values. Additionally, midazolam use was more prevalent in the hypoxia group, whereas propofol use was significantly higher in the non-hypoxic group (p<0.05). Gastric biopsy findings, including the presence of Helicobacter pylori, atrophy, and metaplasia, did not differ significantly between the groups (p>0.05). Conclusion: Critically ill PEG patients with tissue hypoxia exhibited distinct laboratory profiles and sedation requirements compared to non-hypoxic patients. However, endoscopic gastric biopsy findings were largely comparable between the groups. These results highlight the importance of individualized sedation strategies and supportive management for critically ill patients undergoing PEG.