Arterial Oxygen Saturation During Emergency Esophagogastroduodenoscopy

Db, Hill; Bd, Stokes; Nh, Gilinsky

doi:10.1097/00004836-199406000-00005

Cited by 8 publications

(8 citation statements)

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“…Some studies have shown that early endoscopy might be associated with more complications than delayed endoscopy, such as significant oxygen desaturation 16,17. According to our results, we suggest that early endoscopy need not be unconditionally performed in patients with bleeding peptic ulcers.…”

Section: Discussionmentioning

confidence: 54%

Comparison of the Effectiveness of Interventional Endoscopy in Bleeding Peptic Ulcer Disease according to the Timing of Endoscopy

Cho¹,

Han²,

Ahn³

et al. 2009

Gut Liver

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Background/AimsThe optimal timing for interventional endoscopy in bleeding peptic ulcer disease is controversial. This study compared the outcomes between early endoscopy and delayed endoscopy in patients with bleeding peptic ulcer disease.MethodsWe conducted a prospective analysis of data from 90 patients with bleeding peptic ulcer disease who visited the emergency room between May 2006 and September 2007. Patients were categorized into two groups: the early-endoscopy group (admitted during the daytime or at night with prompt endoscopic management) and the delayed-endoscopy group (admitted at night or during weekends, with endoscopic management delayed until the next day). We compared the clinical outcomes of endoscopy between the two groups.ResultsThere were 49 patients in the early-endoscopy group and 41 patients in the delayed-endoscopy group. Patient demographics, clinical characteristics, bleeding control modality, and Rockall score did not differ between the two groups. There were also no significant differences between the early- and delayed-endoscopy groups in the re-bleeding rate (3/49 vs 5/41, p=0.313), the duration of hospital stay (10.7 vs 9.3 days, p=0.437), and the total amount of blood transfused (3.4 vs 2.7 units, p=0.240).ConclusionsThe effectiveness of interventional endoscopy for patients with bleeding peptic ulcer disease is not significantly affected by the timing of endoscopy.

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Section: Discussionmentioning

confidence: 54%

Comparison of the Effectiveness of Interventional Endoscopy in Bleeding Peptic Ulcer Disease according to the Timing of Endoscopy

Cho¹,

Han²,

Ahn³

et al. 2009

Gut Liver

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“…13,14 Nonetheless, mortality rate has remained unchanged despite therapeutic endoscopy, 15 and an increased rate of compli-cations with early vs delayed endoscopy has been reported. 16,17 The controversy is further confounded by the paucity of literature specifically addressing the timing of endoscopy and by the lack of clear guidelines on the timing of endoscopy in major consensus statements. 7,8 In the absence of clear guidelines, early endoscopy is presently an inconsistent practice.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,15 Moreover, some indirect evidence suggests that early endoscopy may be associated with more complications than delayed endoscopy. 16,17 Only 1 study 16 directly assessed the safety of early endoscopy, suggesting that it may result in an increased risk of oxygen desaturation. However, this study used early endoscopy disproportionately in a high-risk group, and all other studies identified suggest that early endoscopy is safe.…”

Section: Commentmentioning

confidence: 99%

Endoscopy for Acute Nonvariceal Upper Gastrointestinal Tract Hemorrhage: Is Sooner Better?

Spiegel¹,

Vakil²,

Ofman³

2001

Arch Intern Med

180

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The overwhelming majority of existing data suggest that early endoscopy is safe and effective for all risk groups. The clinical and economic outcomes of early endoscopy should be confirmed in additional well-designed randomized controlled trials. Given the strength of the evidence, efforts to develop a more standardized and time-sensitive approach to acute nonvariceal upper gastrointestinal tract hemorrhage should be undertaken.

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“…Similarly, endoscopy on the day of admission was associated with a 45% increase in the odds of death. These findings suggest that American clinicians are appropriately triaging their patients such that especially sick individuals receive accelerated endoscopy whereas endoscopy is delayed in those who are less severely ill. An alternative, but far less likely explanation, is that early endoscopy is harmful, for example, due to an increased risk of complications such as oxygen desaturation (29).…”

Section: Los and Hospital Chargesmentioning

confidence: 99%

The Effect of Weekend versus Weekday Admission on Outcomes of Esophageal Variceal Hemorrhage

Myers

Kaplan

Shaheen

2009

Canadian Journal of Gastroenterology

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Arterial Oxygen Saturation During Emergency Esophagogastroduodenoscopy

Cited by 8 publications

References 0 publications

Comparison of the Effectiveness of Interventional Endoscopy in Bleeding Peptic Ulcer Disease according to the Timing of Endoscopy

Comparison of the Effectiveness of Interventional Endoscopy in Bleeding Peptic Ulcer Disease according to the Timing of Endoscopy

Endoscopy for Acute Nonvariceal Upper Gastrointestinal Tract Hemorrhage: Is Sooner Better?

The Effect of Weekend versus Weekday Admission on Outcomes of Esophageal Variceal Hemorrhage

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