• Critical care medicine · Mar 1991

    Pulmonary aspiration during emergency endoscopy in patients with upper gastrointestinal hemorrhage.

    • B Lipper, D Simon, and F Cerrone.
    • Department of Medicine, Albert Einstein College of Medicine, Bronx Municipal Hospital Center, NY.
    • Crit. Care Med. 1991 Mar 1;19(3):330-3.

    ObjectiveTo evaluate the frequency and significance of aspiration and its clinical importance in patients with upper GI bleeding undergoing esophagogastroduodenoscopy in the ICU.DesignThirty consecutive patients with active and severe upper GI bleeding were studied.SettingICU.PatientsRanged in age from 20 to 78 yr with an equal number of males and females.InterventionsAll patients had continuous pulse oximetry monitoring and had chest radiographs obtained less than 12 hr before endoscopy and less than 4 hr after endoscopy.MeasurementsSix (20%) of 30 patients developed new lung infiltrates after esophagogastroduodenoscopy. In this group of patients, preendoscopy chest radiographs were obtained after less than 4 hr. In five of these patients, infiltrates were accompanied by fever and/or leukocytosis and oxygen desaturation to less than 90% during the esophagogastroduodenoscopy.ConclusionClinically significant aspiration pneumonia frequently complicates esophagogastroduodenoscopy in upper GI bleeding patients and is an important mechanism of esophagogastroduodenoscopy-induced hypoxia.

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