Pulmonary aspiration during emergency endoscopy in patients with upper gastrointestinal hemorrhage.

Abstract

To evaluate the frequency and significance of aspiration and its clinical importance in patients with upper GI bleeding undergoing esophagogastroduodenoscopy in the ICU. Thirty consecutive patients with active and severe upper GI bleeding were studied. ICU. Ranged in age from 20 to 78 yr with an equal number of males and females. All patients had continuous pulse oximetry monitoring and had chest radiographs obtained less than 12 hr before endoscopy and less than 4 hr after endoscopy. Six (20%) of 30 patients developed new lung infiltrates after esophagogastroduodenoscopy. In this group of patients, preendoscopy chest radiographs were obtained after less than 4 hr. In five of these patients, infiltrates were accompanied by fever and/or leukocytosis and oxygen desaturation to less than 90% during the esophagogastroduodenoscopy. Clinically significant aspiration pneumonia frequently complicates esophagogastroduodenoscopy in upper GI bleeding patients and is an important mechanism of esophagogastroduodenoscopy-induced hypoxia.