Gastrostomies et nutrition entérale lors des maladies neuromusculaires |
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| Institution: | 1. Unité de nutrition, centre de spécialité de l’obésité sévère (CSO) du Limousin, CHU Dupuytren, avenue Martin-Luther-King, 87042 Limoges cedex, France;2. Centre de spécialité de l’obésité sévère du Limousin, CHU Dupuytren, avenue Martin-Luther-King, 87042 Limoges cedex, France;3. Inserm UMR 1094, rue du Docteur-Marcland, 87032 Limoges cedex, France;1. Renal Division, Department of Medicine, Brigham & Women’s Hospital, Boston, MA;2. Cardiovascular Division, Department of Medicine, Brigham & Women’s Hospital, Boston, MA;3. Renal Division, Northwestern University, Chicago, IL;4. Nephrology and Dialysis Unit, Azienda Ospedaliera Papa Giovanni XXIII, IRCCS-Instituto di Ricerche Farmacologiche Mario Negri, Bergamo and Department of Biomedical and Clinical Sciences, Milan, Italy;5. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia;6. Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO;7. Department of Medical Endocrinology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark;8. Division of Nephrology, Health Sciences Centre, St. John’s, NF, Canada;9. Division of Nephrology, University of Sao Paulo Medical School, Sao Paulo, Brazil;10. Nephrology Division, Tufts University School of Medicine, Boston, MA;11. Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, the Netherlands;12. Department of Nephrology Hypertension, University of Erlangen-Nürnberg, Erlangen, Germany;13. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland;1. Department of Surgery, Alcohol Research Program, Burn & Shock Trauma Research Institute, Loyola University Chicago Health Sciences Division, Maywood, IL, United States;2. Southern California Research Center for ALPD, Cirrhosis and Department of Pathology, University of Southern California, Greater Los Angeles Veterans Affairs Health Care System, Los Angeles, CA, United States;3. National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States;4. Department of Internal Medicine, Division of Hypothalamic Research, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, United States;5. Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, United States;6. Department of Surgery, Emory University, Atlanta, GA, United States;7. Alcohol Research Program, Burn Research Program, Division of GI, Trauma and Endocrine Surgery, Department of Surgery, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, United States;8. Department of Physiology, University of Tennessee Health Science Center, Memphis, TN, United States;9. Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States;10. Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, United States;11. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States;12. Department of Basic Pharmaceutical Sciences, High Point University Fred Wilson School of Pharmacy, High Point, NC, United States;13. Department of Dermatology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, United States;14. Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States;1. Jichi Medical University, Center of Community Medicine, Tochigi, Japan;2. Nagoya City University Graduate School of Medicine, Department of Community-based Medical Education, Aichi, Japan;3. Yurin Hospital, Tokyo, Japan;4. Waseda University, Regional and Inter-Regional Studies, Tokyo, Japan;1. Unité d’assistance nutritionnelle, unité transversale de nutrition, CHU de Nancy-Brabois adulte, 54500 Vand?uvre-lès-Nancy, France;2. Unité multidisciplinaire de chirurgie de l’obésité, CHU de Nancy-Brabois adulte, 54500 Vand?uvre-lès-Nancy, France;3. Service de diabétologie-maladies métaboliques et nutrition, CHU de Nancy-Brabois adulte, 4, rue du Morvan, 54500 Vand?uvre-lès-Nancy, France |
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| Abstract: | Neuromuscular diseases (NMD) are disorders of often severe prognosis, and can easily lead to malnutrition. Swallowing disorders are frequent, and the patients can profit from enteral nutrition (EN), for which the way of election is gastrostomy. The aim of this review is to give a progress report on the evolution of NMD care since the 2000s for amyotrophic lateral sclerosis (ALS), the best explored disease, and for the other NMD. For ALS, percutaneous endoscopic gastrostomy (PEG) is the main method used, competed with because of its relative simplicity by radiological inserted gastrostomy (RIG). The indications are swallowing disorders, loss of weight, insufficient feeding, and difficulties of catching the meals. Current studies, not enough methodologically valuable, does not allow to affirm that EN improves survival of the patients nor their quality of life, but it could improve nutritional status. The complications after gastrostomy are aspecific, similar between PEG and RIG but the methods of evaluation are imprecise. The PEG is desirable if the patients forced vital capacity (FVC) is >50%. RIG is needed when FVC is <50%, after PEG failure or if the patients are in bad general condition. Documentation is limited for other NMD, including particularly child diseases and Duchenne muscular dystrophy (DMD). The indications and complications of gastrostomy are close to those of the ALS. EN improves patients nutritional status and, in DMD, quality of life. The families, the patients and the medical teams, often because of an insufficient communication, can be reserved considering nutrition support. |
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| Keywords: | Neuromuscular disease Enteral nutrition Gastrostomy |
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