Digestive Diseases and Sciences

, Volume 52, Issue 9, pp 2225–2228

Risk of Aspiration Pneumonia in Suspected Variceal Hemorrhage: The Value of Prophylactic Endotracheal Intubation Prior to Endoscopy

  • David G. Koch
  • Miguel R. Arguedas
  • Michael B. Fallon
Original Article

DOI: 10.1007/s10620-006-9616-0

Cite this article as:
Koch, D.G., Arguedas, M.R. & Fallon, M.B. Dig Dis Sci (2007) 52: 2225. doi:10.1007/s10620-006-9616-0

Abstract

Variceal hemorrhage (VH) is a lethal complication of portal hypertension. Aspiration occurring during endoscopic intervention for acute VH is a concern; however, few data exist regarding the efficacy of prophylactic intubation to prevent aspiration pneumonia. We reviewed all endoscopic procedures for acute VH from January 1995 to December 2002; only patients with the absence of hepatic encephalopathy greater than stage II and normal chest x-ray at admission were included. The use of prophylactic intubation, postprocedure chest x-ray, and mortality were recorded. Sixty-two patients (69 bleeding episodes) were identified. Elective intubation was performed in 42 patients (47 episodes); pulmonary infiltrates developed in 7 of 42 (17%), with an overall mortality rate of 9 of 42 (21%). Twenty patients (22 episodes) were not intubated. None developed pulmonary infiltrates, and the overall mortality rate was 1 in 20 (5%). We conclude that in patients with suspected variceal bleeding, elective intubation is associated with a substantial risk of aspiration pneumonia.

Keywords

Gastrointestinal hemorrhage Esophageal varices Endoscopy Aspiration pneumonia Endotracheal intubation Hepatic encephalopathy 

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • David G. Koch
    • 1
    • 3
  • Miguel R. Arguedas
    • 2
  • Michael B. Fallon
    • 2
  1. 1.Department of Internal MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Division of Gastroenterology & HepatologyUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Digestive Disease CenterMedical University of South CarolinaCharlestonUSA

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