Document Detail

Prospective Description of Coughing, Hemodynamic Changes, and Oxygen Desaturation During Endoscopic Sedation.
MedLine Citation:
PMID:  22271416     Owner:  NLM     Status:  Publisher    
BACKGROUND: Deep sedation is increasingly used for endoscopy. The impact of sedation level on hemodynamic status, oxygenation, and aspiration risk is incompletely described. AIMS: To describe the incidence of intraprocedural cough, hemodynamic changes, oxygen desaturation, and their relationship to clinical factors and sedation level. METHODS: Detailed prospective recordings of hemodynamic changes, oxygen desaturation, and cough during 757 nonemergent endoscopic procedures done under sedation using propofol, midazolam, and/or fentanyl. RESULTS: Thirteen percent of patients had at least one cough and 3% had prolonged cough. Cough was more common in nonsmokers (P = 0.05), upper endoscopy (P < 0.0001), with propofol (P = 0.0008), longer procedures (P = 0.0001), and hiccups (P = 0.01). The association between supine positioning during colonoscopy and cough approached significance (P = 0.06). Oxygen desaturation was rare (4%) and associated only with deep sedation (P = 0.02). Mean systolic and diastolic blood pressure (BP) dropped by 7.3 and 5.6% respectively. Decreases in systolic BP were more common in whites (P = 0.03), males (P = 0.004), nonsmokers (P = 0.04), during colonoscopy (P < 0.0001), and in patients receiving midazolam and fentanyl (P = 0.01). Heart rate (HR) dropped >20% from baseline in 15% of patients and was more common during colonoscopy (P = 0.002). HR increased >20% in 20% of patients and was more common with coughing (P < 0.0001) and in younger patients (P = 0.0002). No patient required pharmacologic treatment of BP or HR. CONCLUSIONS: We have described procedural predictors of cough that may help clinicians reduce the risk of aspiration during endoscopy. Hemodynamic changes during endoscopy are common but largely clinically insignificant.
Abdul Hamid El Chafic; George Eckert; Douglas K Rex
Related Documents :
8949966 - Thiamine pyrophosphate effect and normalized erythrocyte transketolase activity ratio i...
11491166 - Nasal potential difference measurements in patients with atypical cystic fibrosis.
20043056 - Oral submucous fibrosis in a young patient.
17890246 - Nephrogenic systemic fibrosis after exposure to gadolinium in patients with renal failure.
20015916 - Cardiac autonomic profile in rheumatoid arthritis and systemic lupus erythematosus.
18180256 - Does the patient history predict hepatotoxicity after acute paracetamol overdose?
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-24
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  -     ISSN:  1573-2568     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, 550 N. University Boulevard, IU Hospital #4100, Indianapolis, IN, 46202, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Gene Transfer of c-met Confers Protection Against D: -Galactosamine/Lipopolysaccharide-Induced Acute...
Next Document:  New Biobased High Functionality Polyols and Their Use in Polyurethane Coatings.