Monitoring of blood pressure and heart rate during routine endoscopy: a prospective, randomized, controlled study.
Six hundred and eighteen patients were randomized to have automated cardiovascular monitoring or clinical observation during routine endoscopy. Hemodynamic parameters were recorded at 3-min intervals before, during, and after the procedure. Upper gastrointestinal endoscopy resulted in an increased heart rate (HR), while colonoscopy caused a decreased blood pressure (BP) and HR. Hemodynamic aberrations occurred in 71% of monitored patients, including hypotension 6%, hypertension 30%, bradycardia 26%, and tachycardia 32%. Only one-third of the hypotensive episodes were recognized as aberrations, and therapeutic intervention did not improve outcome. No monitored or control patient had an adverse result. Certain hemodynamic changes were directly correlated with the baseline BP or HR and associated with the presence of coronary artery disease, particular medicines with cardiovascular effects and longer procedure duration. We conclude that automated monitoring during routine endoscopy unmasks frequent hemodynamic aberrations that are clinically insignificant. Routine monitoring during endoscopy does not improve outcome.
DiSario
J A
JA
Gastroenterology Section, Carl T. Hayden VA Medical Center, Phoenix, Arizona.
Waring
J P
JP
Talbert
G
G
Sanowski
R A
RA
D000368:Aged; D001331:Automation; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D003113:Colonoscopy / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic