The Role of the Integrated Pulmonary Index in Determining Respiratory Complications in Patients Undergoing Upper Gastrointestinal Endoscopy Under Sedation

Abstract

Objective: In this study, we aimed to evaluate the respiratory complications defined by the Integrated Pulmonary Index (IPI) in patients with comorbid risk factors who underwent Upper gastrointestinal endoscopy (UGE) under sedation. Methods: This cross-sectional, prospective study was conducted with 157 patients, aged over 18 years, in our endoscopy unit between July 2020 and December 2020. Patients' demographic data, body mass index (BMI), ASA class and comorbidities were recorded. The mean arterial pressure (MAP), and HR, RR, SpO2, EtCO2 for the IPI were measured as baseline values and 5 minutes of the procedure and compared between two groups as the patients who developed (Group I) and did not develop (Group II) complications. Results: The mean BMI value was statistically significantly higher in Group I compared to Group II (p<0.001). The mean HR was statistically significantly higher and IPI score significantly lower in Group I than in Group II before the procedure (p=0.013, p=0.01; respectively). The mean SpO2, EtCO2 and IPI values were statistically significantly lower in Group I compared to Group II at 5 minutes of the procedure (p=0.001, p=0.004, p=0.010; respectively). The frequency of comorbidities was statistically significantly higher in Group I. In the logistic regression analysis, BMI value was found as an independent factor affecting the development of respiratory complications. Conclusion:The mean IPI scores dropped significantly in patients who developed complications, mainly due to the decreases in EtCO2 and SpO2 values at 5 minutes of the procedure. BMI was determined as a risk factor for the development of respiratory complications. IPI monitoring can provide guidance during sedation of patients with comorbid diseases undergoing UGE.