title: Non-invasive ventilation during upper endoscopies in adult patients. A systematic review.
abstract: BACKGROUND
  Upper endoscopies (UE) are widely performed. Non-invasive ventilation (NIV) during UE has been used to avoid respiratory complications, mainly in high-risk or sedated patients. We performed a systematic review on this topic.
  
  
  METHODS
  BioMedCentral, PubMed, Embase and the Cochrane Central Register of Clinical Trials were searched (updated September 1, 2012). Further searches involved conference proceedings.
  
  
  RESULTS
  We included in this systematic review 27 papers out of 405 publications retrieved. Ten studies reported the use without complications of NIV to assist fiberoptic bronchoscopy (FOB) and broncho-alveolar lavage (BAL). Ten studies described the use of NIV in fiberoptic-guided tracheal intubations. The authors reported no complications, even in hypoxemic patients and they observed only one failure (0.4%). Three studies evaluated the effectiveness of NIV during placement of percutaneous endoscopic gastrostomy in patients with neuromuscular diseases. In this group the failure rate was 4.4%. One study described the successful use of NIV in sedated patients undergoing gastroscopy. Three studies reported the successful application of NIV during trans-esophageal echocardiography. Overall, the procedure could not be performed due to inability of NIV to maintain safe intra-procedural ventilation in four out of total 515 cases of NIV-aided UE, suggesting a success rate higher than 99.2%.
  
  
  CONCLUSIONS
  This is the first systematic review addressing the use of NIV during upper endoscopies. Its use seems feasible, and based on the limited data available NIV appears safe and likely effective. The patients who would benefit the most are: high-risk and patients undergoing sedation.
authors: Department of Anesthesia and Intensive Care, Vita-Salute University and San Raffaele Hospital, Milan, Italy. cabrini.luca@hsr.it
authors: L
authors: L
authors: Cabrini
authors: L
authors: L
authors: Nobile
authors: E
authors: E
authors: Cama
authors: G
authors: G
authors: Borghi
authors: M
authors: M
authors: Pieri
authors: S
authors: S
authors: Bocchino
authors: A
authors: A
authors: Zangrillo
mesh_terms: D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy / Q000009:adverse effects; D016292:Procedural Sedation; D017548:Echocardiography, Transesophageal; D004724:Endoscopy / Q000379:methods*; D005773:Gastroscopy; D006801:Humans; D000860:Hypoxia / Q000628:therapy; D063087:Noninvasive Ventilation / Q000379:methods*