PMID- 10774967
OWN - NLM
STAT- MEDLINE
DCOM- 20000620
LR  - 20071115
IS  - 0013-726X (Print)
IS  - 0013-726X (Linking)
VI  - 32
IP  - 4
DP  - 2000 Apr
TI  - Changes in cardiopulmonary parameters during upper gastrointestinal endoscopy in 
      patients with heart disease: towards safer endoscopy.
PG  - 287-93
AB  - BACKGROUND AND STUDY AIMS: Gastrointestinal endoscopy is an invasive examination. 
      The aims of this study were to elucidate the effects and risks of upper 
      gastrointestinal endoscopy with regard to cardiopulmonary functions in patients 
      with heart disease, and to establish safety guidelines for use during endoscopy 
      in this particular group of patients. PATIENTS AND METHODS: The patients involved 
      were 53 inpatients in whom upper gastrointestinal endoscopy was carried out 
      before cardiac surgery. Their cardiac functions had been evaluated previously. 
      Electrocardiography with two leads (II, V5) was used, and blood pressure and 
      peripheral oxygen saturation (SpO2) were monitored throughout the procedure. The 
      relationship between the changes in cardiopulmonary parameters during endoscopy 
      and the cardiac functions was analyzed. RESULTS: Heart rate increased immediately 
      after insertion of the endoscope (P < 0.01). There was a significantly higher 
      incidence of ventricular and supraventricular extrasystoles during observation of 
      the second portion of the duodenum (P < 0.05). A lower cardiac index (P < 0.05) 
      and a higher New York Heart Association (NYHA) functional classification (P < 
      0.05) were found in patients with oxygen desaturation than in patients without 
      it. Two patients with severe coronary artery lesions showed marked ST-T 
      depression, and these ischemic changes were thought to be due to increase in 
      cardiac work during endoscopy. CONCLUSIONS: Upper gastrointestinal endoscopy has 
      many adverse effects on cardiopulmonary functions in patients with heart disease. 
      In our study, the clinical value of very close monitoring and administration of 
      oxygen for patients with heart disease was confirmed by objective data.
FAU - Yazawa, K
AU  - Yazawa K
AD  - Dept. of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
FAU - Adachi, W
AU  - Adachi W
FAU - Koide, N
AU  - Koide N
FAU - Watanabe, H
AU  - Watanabe H
FAU - Koike, S
AU  - Koike S
FAU - Hanazaki, K
AU  - Hanazaki K
LA  - eng
PT  - Clinical Trial
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
SB  - IM
MH  - Aged
MH  - Arrhythmias, Cardiac/diagnosis/etiology
MH  - Blood Pressure Determination
MH  - Cardiovascular Diseases/*diagnosis/*physiopathology
MH  - *Electrocardiography
MH  - Endoscopy, Gastrointestinal/*adverse effects/methods
MH  - Female
MH  - Heart Rate/physiology
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic/methods
MH  - Oxygen Consumption/physiology
MH  - Probability
MH  - Reference Values
MH  - Risk Assessment
MH  - Statistics, Nonparametric
EDAT- 2000/04/25 09:00
MHDA- 2000/06/24 11:00
CRDT- 2000/04/25 09:00
PHST- 2000/04/25 09:00 [pubmed]
PHST- 2000/06/24 11:00 [medline]
PHST- 2000/04/25 09:00 [entrez]
AID - 10.1055/s-2000-7377 [doi]
PST - ppublish
SO  - Endoscopy. 2000 Apr;32(4):287-93. doi: 10.1055/s-2000-7377.