PMID- 30993168
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 7
IP  - 4
DP  - 2019 Apr
TI  - Safety and efficacy of non-anesthesiologist administration of propofol sedation 
      during esophagogastroduodenoscopy in the intensive care unit.
PG  - E625-E629
LID - 10.1055/a-0829-6284 [doi]
AB  - Background and study aims  Propofol sedation is an increasingly popular method of 
      sedation for gastrointestinal endoscopic procedures. The safety and efficacy of 
      the non-anesthesiologist administration of propofol (NAAP) sedation has been 
      demonstrated in the ambulatory setting. However, NAAP sedation in intensive care 
      unit (ICU) patients has not been reported. The purpose of this study is to 
      determine safety and efficacy of NAAP sedation in an ICU population. Methods  We 
      retrospectively reviewed esophagogastroduodenoscopies (EGD) performed with NAAP 
      sedation in our intensive care units from June 2014 to September 2016. All EGDs 
      were performed for evaluation of gastrointestinal bleeding. The primary end point 
      of this study was to analyze the incidence of sedation-related adverse events 
      (AEs). The secondary end points included successful completion of procedure and 
      any endoscopic interventions performed. Results  Two of 161 procedures (1.2 %) 
      had sedation-related AEs requiring procedure termination. One hundred forty-six 
      of 161 procedures (90.7 %) were successfully completed. Incomplete procedures 
      were due to excess heme, retained food or obstructive lesions (13/161, 8.1 %). 
      Endoscopic intervention was performed successfully in 17/24 cases (70.8 %) that 
      had endoscopically treated lesions identified. One hundred six of 161 patients 
      (66 %) were American Society of Anesthesiologists (ASA) classification III or IV. 
      Conclusion  Our retrospective analysis demonstrated that EGDs can be successfully 
      completed in ICU patients using NAAP sedation. When procedures cannot be 
      completed, it is rarely due to sedation-related AEs. NAAP sedation further allows 
      adequate examination and successful treatment of high-risk lesions. NAAP sedation 
      appears safe and effective for endoscopic procedures in the ICU setting.
FAU - Patel, Janaki
AU  - Patel J
AD  - Department of Internal Medicine, Division of Gastroenterology and Hepatology, 
      University of Utah School of Medicine, Salt Lake City, Utah, United States.
FAU - Fang, John
AU  - Fang J
AD  - Department of Internal Medicine, Division of Gastroenterology and Hepatology, 
      University of Utah School of Medicine, Salt Lake City, Utah, United States.
FAU - Taylor, Linda J
AU  - Taylor LJ
AD  - Department of Internal Medicine, Division of Gastroenterology and Hepatology, 
      University of Utah School of Medicine, Salt Lake City, Utah, United States.
FAU - Adler, Douglas G
AU  - Adler DG
AD  - Department of Internal Medicine, Division of Gastroenterology and Hepatology, 
      University of Utah School of Medicine, Salt Lake City, Utah, United States.
FAU - Gawron, Andrew J
AU  - Gawron AJ
AD  - Department of Internal Medicine, Division of Gastroenterology and Hepatology, 
      University of Utah School of Medicine, Salt Lake City, Utah, United States.
LA  - eng
PT  - Journal Article
DEP - 20190412
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC6461546
COIS- Competing interests None
EDAT- 2019/04/18 06:00
MHDA- 2019/04/18 06:01
PMCR- 2019/04/01
CRDT- 2019/04/18 06:00
PHST- 2018/08/30 00:00 [received]
PHST- 2018/11/15 00:00 [accepted]
PHST- 2019/04/18 06:00 [entrez]
PHST- 2019/04/18 06:00 [pubmed]
PHST- 2019/04/18 06:01 [medline]
PHST- 2019/04/01 00:00 [pmc-release]
AID - 10.1055/a-0829-6284 [doi]
PST - ppublish
SO  - Endosc Int Open. 2019 Apr;7(4):E625-E629. doi: 10.1055/a-0829-6284. Epub 2019 Apr 
      12.