| Carbon dioxide retention and oxygen desaturation during gastrointestinal endoscopy. | |
MedLine Citation:
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PMID: 8335187 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pulse oximetry measures arterial oxygen saturation (SpO2), not hypoventilation, which is directly reflected by increases in carbon dioxide tension. METHODS: In the present study, transcutaneous carbon dioxide tension (PtcCO2) and SpO2 were measured during 101 endoscopic procedures selected for long duration or comorbid illnesses, and relationships between hypercapnia and hypoxemia were evaluated. Nasal oxygen was administered only for sustained desaturation (SpO2 < 90%). RESULTS: Mean peak increase in PtcCO2 was significantly higher in patients requiring oxygen for sustained desaturation (16.3 mm Hg; range, 4-52) than in patients breathing room air who had transient or no desaturation (10.2 mm Hg [range, 3-19] and 5.1 mm Hg [range, 0-15]). If nasal oxygen corrected desaturation, even transient recurrence of desaturation indicated worsening CO2 retention, which preceded respiratory arrest in one patient. Independent predictors of hypercapnia were fentanyl and midazolam doses, oxygen requirement, and dementia. CONCLUSIONS: Severe hypoventilation may occur during endoscopy, undetected by clinical observation or pulse oximetry, but only in sedated patients who require supplemental oxygen to maintain SpO2 above 90%. After oxygen supplementation corrects desaturation, recurrence of desaturation implies severe hypoventilation and warrants limitation of further sedation. |
Authors:
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M L Freeman; J T Hennessy; O W Cass; A M Pheley |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gastroenterology Volume: 105 ISSN: 0016-5085 ISO Abbreviation: Gastroenterology Publication Date: 1993 Aug |
Date Detail:
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Created Date: 1993-08-26 Completed Date: 1993-08-26 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0374630 Medline TA: Gastroenterology Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 331-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anoxia / etiology Carbon Dioxide / metabolism* Digestive System / metabolism*, pathology* Endoscopy* / adverse effects Forecasting Humans Hypercapnia / etiology Middle Aged Oxygen / blood* Respiration Skin / metabolism* |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
| Comments/Corrections | |
Comment In:
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Gastroenterology. 1994 Mar;106(3):820-1
[PMID:
8119558
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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