Percutaneous endoscopic gastrostomy tube placement in patients with extracorporeal membrane oxygenation

Figures & data

Fig. 1.  Illustration shows typical percutaneous gastrostomy (PEG) procedure on the patient on venoarterial: extracorporeal membrane oxygenation (ECMO) on left (A), and PEG procedure on the patient with HeartMate II left ventricular assist device (LVAD) on right (B). Prior PEG procedure, an intensivists draw line for the anticipate LVAD placement, which should not overlap to the PEG stoma.

Table 1.  Patients demographics

Patient	Age	Sex	Type of ECMO	Indication	Total length on ECMO (days)	ECMO-PEG (days)	Prealbumin before PEG (mg/dl)	Prealbumin after PEG (mg/dl)	PTT at time of PEG	Outcome
1	53	M	VV to VA	ARDS	27	14	14	29	29	Unable to recover from ARDS, care withdrawn
2	47	F	VV	ARDS	28	14	16	16	47^a	ECMO was weaned in success
3	66	F	VA	Cardiogenic shock	18	16	9	11	33	ECMO was weaned in success
4	56	M	VA	Cardiogenic shock	40	23	5	14	28	Unable to recover from pneumonia, ARDS, care withdrawn

a ARDS: adult respiratory distress syndrome; ECMO: extracorporeal membrane oxygenation; PEG: percutaneous gastrostomy; PTT: partial thrombin time; VA: venoarterial ECMO; VV: venovenous ECMO.

This patient was on argatroban for heparin induced thrombocytopenia.