Pulmonary aspiration during emergency endoscopy in patients with upper gastrointestinal hemorrhage.
OBJECTIVE
To evaluate the frequency and significance of aspiration and its clinical importance in patients with upper GI bleeding undergoing esophagogastroduodenoscopy in the ICU.


METHODS
Thirty consecutive patients with active and severe upper GI bleeding were studied.


METHODS
ICU.


METHODS
Ranged in age from 20 to 78 yr with an equal number of males and females.


METHODS
All patients had continuous pulse oximetry monitoring and had chest radiographs obtained less than 12 hr before endoscopy and less than 4 hr after endoscopy.


METHODS
Six (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.


CONCLUSIONS
Clinically significant aspiration pneumonia frequently complicates esophagogastroduodenoscopy in upper GI bleeding patients and is an important mechanism of esophagogastroduodenoscopy-induced hypoxia.
Lipper
B
B
Department of Medicine, Albert Einstein College of Medicine, Bronx Municipal Hospital Center, NY.
Simon
D
D
Cerrone
F
F
D000328:Adult; D000368:Aged; D003422:Critical Care; D004630:Emergencies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D005773:Gastroscopy / Q000009:adverse effects*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D012189:Retrospective Studies