Bedside Gastrostomy: PUG

Bedside gastrostomy is the next phase in improving patient care for critically ill patients.  Percutaneous ultrasound gastrostomy (PUG) is a bedside medical procedure designed to improve patient outcomes and increase efficiency. PUG allows critical care physicians to perform routine bedside gastrostomies similar to the way that practice changes have enabled percutaneous bedside tracheostomies. 

PUG is an alternative to percutaneous endoscopic gastrostomy (PEG), a procedure that often requires that a critically ill patient be transferred to a surgeon or a specialist in the operating or endoscopy suite. 

PUG allows critical care physicians to perform routine bedside gastrostomies through innovative use of familiar and well-established technologies.  

Percutaneous Ultrasound Gastrostomy Offers Better Visualization with Less Risk

PUG is an ultrasound-guided procedure that offers much greater visualization than conventional endoscopically-guided gastrostomy tube placement. PUG uses magnets help bring the planes of tissue together, so the ultrasound images can guide the physician to identify the ideal site for G-tube insertion. PUG ultrasound visualizes the patient’s tissue in real-time, protecting vasculature and critical anatomy from accidental perforation during tract formation. 

PUG utilizes readily available medical technologies like balloon catheters, guidewires and access needles to create an opening into the stomach to provide nutritional support or gastric decompression. Unlike PEG, PUG uses ultrasound to enable better tissue visualization with less risk and greater efficiency.

Just as critical care physicians now perform percutaneous tracheostomies at a patient’s bedside, PUG enables physicians to complete bedside gastrostomies. 

PUG Benefits for the Critical Care Physician

  • Faster G-tube placement (no consults)

  • Better visualization of large blood vessels and colon prior to G-tube placement

  • Bedside gastrostomy

  • End to end patient care

Benefits for the Interventional Radiologist

  • Increased IR suite efficiency

  • Quicker gastrostomy procedure (no external dilation)

  • Easier visualization of large blood vessels and colon prior to G-tube placement

  • Unlike fluoroscopy, no exposure to ionizing radiation