Key result
Pulse oximetry and supplemental oxygen fail to reduce morbidity or mortality during gastrointestinal endoscopy.
Why the study?
The appropriate degree of monitoring and prophylactic measures during sedated gastrointestinal endoscopy is uncertain, and current guidelines lack scientific support.
Does pulse oximetry monitoring and supplemental oxygen reduce morbidity or mortality in sedated patients undergoing gastrointestinal endoscopy?
Does pulse oximetry monitoring and supplemental oxygen reduce morbidity or mortality in sedated patients undergoing gastrointestinal endoscopy?
Current guidelines recommending pulse oximetry and supplemental oxygen during gastrointestinal endoscopy are not supported by scientific data demonstrating a reduction in cardiopulmonary morbidity or mortality.
Guidelines lack evidence for routine monitoring; leaves open whether pulse oximetry improves endoscopy outcomes.
A high proportion of the mortality and morbidity associated with endoscopic procedures may be of cardiopulmonary origin. For this reason, the appropriate degree of monitoring and prophylactic measures to be used in the sedated patient undergoing endoscopy has become a topic of discussion during recent years. The development of myocardial ischaemia during gastrointestinal endoscopy has traditionally been considered to be due to the simultaneous arterial hypoxaemia; however, recent investigations have suggested that tachycardia may be a more important pathogenic factor. No study has ever shown that pulse oximetry monitoring or supplemental oxygen will reduce the morbidity or mortality during gastrointestinal endoscopy. The current guidelines for monitoring and oxygen therapy are therefore not supported by scientific data. There is a need for further studies on the pathogenic mechanisms in myocardial ischaemia during endoscopy, and the influence of hypoxaemia on the outcome after upper and lower endoscopy should be clarified.
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Holm et al. (1996) conducted a review in Gastrointestinal endoscopy. Pulse oximetry monitoring and supplemental oxygen was evaluated on Morbidity or mortality. No study has demonstrated that pulse oximetry monitoring or supplemental oxygen reduces morbidity or mortality during gastrointestinal endoscopy, indicating current guidelines lack scientific support.
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