An analysis of upper GI endoscopy done for patients in surgical intensive care: high incidence of, and morbidity from reflux oesophagitis.
OBJECTIVE
To investigate the role of upper gastrointestinal (GI) endoscopy in a surgical intensive care unit [ICU].


METHODS
Retrospective analysis.


METHODS
University hospital, The Netherlands.


METHODS
87 Male and 42 female patients, mean age 62.0 years (range 14-86).


METHODS
198 Upper GI endoscopies.


METHODS
Incidence of, indication for, and abnormalities noted at upper GI endoscopy.


RESULTS
52 (40%) and 18 (14%) patients underwent 82 and 27 upper GI endoscopies, respectively, for evaluation of upper GI haemorrhage and surgical anastomoses. 59 Patients (46%) underwent 89 endoscopies for placement of nasoduodenal feeding tubes (n = 86, 97%), biliary stents (n = 2, 2%) and gastrostomy cathether (n = 1, 1%). The causes of haemorrhage were: oesophagitis (n = 13, 25%), duodenal ulcer (n = 13, 25%), gastric ulcer (n = 7, 13%) and others (n = 14, 28%). In 6 cases (11%), no bleeding site was detected. As a coincidental finding, a third of all patients had oesophagitis. The incidence of haemorrhage in patients treated and not treated by mechanical ventilation was 43/1350 (3.2%) and 9/1470 (0.6%), respectively (p < 0.0001).


CONCLUSIONS
Upper GI endoscopy is a common diagnostic and therapeutic procedure in a surgical ICU. Reflux oesphagitis is often found and is clinically important. Mechanical ventilation is a risk factor for upper GI haemorrhage.
Plaisier
P W
PW
Department of General Surgery, University Hospital Dijkzigt of the Rotterdam Erasmus University, The Netherlands.
van Buuren
H R
HR
Bruining
H A
HA
D003422:Critical Care; D016099:Endoscopy, Gastrointestinal; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors