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应对重症监护病房中的胃肠内镜检查挑战:一篇小型综述。

Navigating gastrointestinal endoscopy challenges in the intensive care unit: A mini review.

作者信息

Jagirdhar Gowthami Sai Kogilathota, Elmati Praveen Reddy, Pattnaik Harsha, Shah Mehul, Surani Salim

机构信息

Department of Medicine, Saint Michaels Medical Center, Newark, NJ 07107, United States.

Department of Anesthesiology, Saint Clair Hospital, Dover, NJ 07801, United States.

出版信息

World J Crit Care Med. 2024 Dec 9;13(4):100121. doi: 10.5492/wjccm.v13.i4.100121.

Abstract

Patients in the intensive care unit (ICU) may need bedside endoscopy for gastrointestinal (GI) emergencies. Conducting endoscopy in the ICU for critically ill patients needs special consideration. This mini review focuses on indications for bedside endoscopes, including GI bleeding, volvulus, and bowel obstruction. It explains the risks associated with urgent endoscopies in critical patients and outcomes. Hemodynamic instability, coagulopathy, and impaired mucosal visualization are important considerations before bedside endoscopy. It also discusses the anesthesia considerations for non-operating room anesthesia. Multidisciplinary collaboration, meticulous patient selection, and procedural optimization help mitigate risks and maximize procedural success.

摘要

重症监护病房(ICU)的患者可能需要床边内镜检查来处理胃肠道(GI)急症。在ICU为重症患者进行内镜检查需要特别考虑。本综述聚焦于床边内镜检查的适应证,包括胃肠道出血、肠扭转和肠梗阻。它解释了危重症患者紧急内镜检查的相关风险及结果。血流动力学不稳定、凝血功能障碍和黏膜可视化受损是床边内镜检查前的重要考量因素。它还讨论了非手术室麻醉的麻醉注意事项。多学科协作、精心的患者选择和操作优化有助于降低风险并使操作成功率最大化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1b7/11577537/9690ff82f28a/100121-g001.jpg

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