Clinical impact of upper gastrointestinal endoscopy in critically ill patients with suspected bleeding

Autor: Sylvain Jean-Baptiste, Jonathan Messika, David Hajage, Stéphane Gaudry, Julie Barbieri, Henri Duboc, Didier Dreyfuss, Benoit Coffin, Jean-Damien Ricard
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Annals of Intensive Care, Vol 8, Iss 1, Pp 1-5 (2018)
Druh dokumentu: article
ISSN: 2110-5820
DOI: 10.1186/s13613-018-0423-5
Popis: Abstract Background and Aims Upper gastrointestinal endoscopies’ (UGE) profitability is undisputable in patients admitted for an overt upper digestive tract bleeding. In critically ill subjects admitted for other causes, its performances have scarcely been investigated despite its broad use. We sought to question the performance of bedside UGE in intensive care unit (ICU) patients, admitted for another reason than overt bleeding. Methods This was a six-year (January 2007–December 2012) retrospective observational study of all UGE performed in a medico-surgical ICU. Exclusion of those performed: in patients admitted for a patent upper digestive bleeding; for a second-look gastroscopy of a known lesion; as a planned interventional procedure. Main demographic and clinical data were recorded; UGE indication and profitability were rated according to its findings and therapeutic impact. Operative values of the indications of UGE were calculated. This study received approval from the Ethics Committee of the French Society of Intensive Care (n° 12-363). Results Eighty-four patients (74% male, mean age 61 ± 14 years) underwent a diagnostic UGE, all for a suspected upper digestive tract bleeding. The main symptoms justifying the procedure were anemia (52%), digestive bleeding (27%), vomiting (15%), hemodynamic instability (3%) and hyperuremia (3%). The profitability of UGE was rated as major (n = 5; 5.8%); minor (n = 34; 40.5%); or null (n = 45; 53.6%). Conclusions When ICU admission is not warranted by a digestive bleeding, UGE has limited diagnostic and therapeutic interest, despite being often performed.
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