Perisetti Abhilash, Kopel Jonathan, Shredi Abdussalam, Raghavapuram Saikiran, Tharian Benjamin, Nugent Kenneth
Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical SciencesLittle RockArkansas.
Department of Internal Medicine, Texas Tech University Health Sciences CenterLubbockTexas.
Proc (Bayl Univ Med Cent). 2019 Jan 15;32(1):22-25. doi: 10.1080/08998280.2018.1530007. eCollection 2019 Jan.
The indications for endotracheal intubation (ETI) during an esophagogastroduodenoscopy (EGD) procedure remain unclear. This study performed a descriptive analysis of patients who underwent prophylactic tracheal intubation during or before an EGD to prevent pulmonary aspiration. We selected patients with an upper gastrointestinal bleed in an intensive care unit who underwent EGD between 2000 and 2013. Eighty-nine patients who underwent pre-EGD tracheal intubation were analyzed. The main outcomes in this study were pulmonary aspiration, length of stay, and mortality. The average age of patients undergoing pre-EGD intubation was 61 years. The incidence of pulmonary aspiration was 38% in patients who underwent pre-EGD tracheal intubation. The patients requiring tracheal intubation had a mortality rate of 22% during hospitalization. Other complications in pre-EGD ETI patients included myocardial infarction (9%), acute respiratory distress syndrome (10%), and pulmonary edema (7%). In conclusion, the incidence of pulmonary aspiration with pre-EGD tracheal intubation in our patients was high (38%). Cardiopulmonary complications including myocardial infarction, acute respiratory distress syndrome, and pulmonary edema were high in intubated patients.
在食管胃十二指肠镜检查（EGD）过程中，气管插管（ETI）的指征仍不明确。本研究对在EGD期间或之前接受预防性气管插管以预防肺误吸的患者进行了描述性分析。我们选择了2000年至2013年间在重症监护病房接受EGD的上消化道出血患者。对89例在EGD前接受气管插管的患者进行了分析。本研究的主要结局是肺误吸、住院时间和死亡率。接受EGD前插管患者的平均年龄为61岁。接受EGD前气管插管患者的肺误吸发生率为38%。需要气管插管的患者在住院期间的死亡率为22%。EGD前ETI患者的其他并发症包括心肌梗死（9%）、急性呼吸窘迫综合征（10%）和肺水肿（7%）。总之，我们的患者中EGD前气管插管的肺误吸发生率很高（38%）。插管患者中心肌梗死、急性呼吸窘迫综合征和肺水肿等心肺并发症发生率很高。
