For a study, researchers sought to determine if introducing bedside percutaneous ultrasound gastrostomy (PUG) would improve efficiency and cost results in ICU patients when compared to traditional gastrostomy treatment. They conducted a retrospective cohort study of ventilator-dependent respiratory failure patients who had a gastrostomy consultation or procedure in the ICU. The presiding attending’s skillset determined whether patients underwent PUG or usual care gastrostomy, and both groups were compared in terms of patient demographics, clinical features, and outcomes. The primary outcomes were the length of stay (LOS) and total hospital costs. The study comprised 88 patients, with 45 in the PUG group and 43 in the usual care gastrostomy group. There were no changes in demographic or clinical features. PUG patients exhibited a considerably lower ICU LOS and hospital LOS, with decreases of 5.0 and 8.7 days, respectively. The PUG group had much lower hospital costs, saving $26,621 per patient. There were no differences in mortality or discharge disposition. Concomitant percutaneous dilatation tracheostomy (PDT) and PUG (“TPUG”) procedures were performed 70% of the time in PUG patients but not in normal care patients. About 53.3% of PUG and 4.6% of normal care gastrostomies had off-hour procedures. In patients with ventilator-dependent respiratory failure, bedside PUG reduced length of stay and total hospital costs. Hospital expenses were dramatically reduced compared to standard care gastrostomy, saving $26,621 per patient.