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J Gastrointestin Liver Dis. 2014 Sep;23(3):255-9. doi: 10.15403/jgld.2014.1121.233.kf1.

Respiratory complications in outpatient endoscopy with endoscopist-directed sedation.

Author information

1
University Hospital of Heidelberg, Department IV, Heidelberg, Germany. Heidelberg, Germany. Kilian.Friedrich@med.uni-heidelberg.de.
2
Department of Social Psychology, University of Mannheim, Mannheim, Germany.
3
University Hospital of Heidelberg, Department IV, Heidelberg, Germany. Heidelberg, Germany.
4
Indiana University Hospital, Department of Gastroenterology, Indianapolis, IN, USA.
5
University Hospital of Heidelberg, Department IV, Heidelberg, Germany. Heidelberg, Germany; Practice of Gastroenterology, Heidelberg, Germany.

Abstract

BACKGROUND AND AIMS:

Respiratory complications represent an important adverse event of endoscopic procedures. We screened for respiratory complications after endoscopic procedures using a questionnaire and followed-up patients suggestive of respiratory infection.

METHOD:

In this prospective observational, multicenter study performed in Outpatient practices of gastroenterology we investigated 15,690 patients by questionnaires administered 24 hours after the endoscopic procedure.

RESULTS:

832 of the 15,690 patients stated at least one respiratory symptom after the endoscopic procedure: 829 patients reported coughing (5.28%), 23 fever (0.15%) and 116 shortness of breath (SOB, 0.74%); 130 of the 832 patients showed at least two concomitant respiratory symptoms (107 coughing + SOB, 17 coughing + fever, 6 coughing + coexisting fever + SOB) and 126 patients were followed-up to assess their respiratory complaints. Twenty-nine patients (follow-up: 22.31%, whole sample: 0.18%) reported signs of clinically evident respiratory infection and 15 patients (follow-up: 11.54%; whole sample: 0.1%) received therefore antibiotic treatment. Coughing or vomiting during the endoscopic procedure resulted in a 156.12-fold increased risk of respiratory complications (95% CI: 67.44 - 361.40) and 520.87-fold increased risk of requiring antibiotic treatment (95% CI: 178.01 - 1524.05). All patients of the follow-up sample who coughed or vomited during endoscopy developed clinically evident signs of respiratory infection and required antibiotic treatment while this occurred in a significantly lower proportion of patients without these symptoms (17.1% and 5.1%, respectively).

CONCLUSIONS:

We demonstrated that respiratory complications following endoscopic sedation are of comparably high incidence and we identified major predictors of aspiration pneumonia which could influence future surveillance strategies after endoscopic procedures.

PMID:
25267952
DOI:
10.15403/jgld.2014.1121.233.kf1
[Indexed for MEDLINE]
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