Prophylactic endotracheal intubation for emergency endoscopy in critically ill patients?

摘要

Endoscopy for upper gastrointestinal (GI) bleeding in the intensive care unit (ICU) is a demanding procedure. There are several recommendation about management, medical, and endoscopic treatment of these emergency situations (Gastrointest Endosc 2004;60:497-504; Gas-trointest Endosc 2005;62:651-655; Gut 2002;51:l- 6). Aspiration and cardiopulmonary complications are the most serious and life-threatening complications of such interventions, occurring in up to 20% of cases (Crit Care Med 1991;19:330-333). In some guidelines or standardized operating procedures of endoscopic units, prophylactic endotracheal intubation is recommended for severe upper GI bleeding to prevent these potential complications (Gut 2002;51:l-6). It is also unclear whether critically ill patients should receive prophylactic intubation for diagnostic or therapeutic upper GI endoscopies.