TY - JOUR

T1 - Anaesthesia in patients undergoing esophago-gastro-duodenoscopy for suspected bleeding

AU - Helsø, Ida

AU - Risom, Martin

AU - Vestergaard, Therese Risom

AU - Foss, Nicolai Bang

AU - Rosenstock, Steffen

AU - Møller, Morten Hylander

AU - Lundstrøm, Lars Hyldborg

AU - Lohse, Nicolai

N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

PY - 2017

Y1 - 2017

N2 - INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a common emergency. Currently, there are no agreed guidelines on the level of anaesthetic support required in patients undergoing acute esophago-gastro-duodendoscopy (EGD).METHODS: An online questionnaire comprising 19 questions was distributed to all members of the Danish Association of Anaesthesiology and Intensive Care (n = 1,418) and the Danish Society of Anaesthesiologists in Training (n = 566). The questions concerned clinical practice for anaesthesia care to patients undergoing EGD for suspected UGIB and availability of local guidelines.RESULTS: A total of 521 anaesthetists who had, on average, concluded medical school 14 years earlier (range: 9-27 years) answered the questionnaire. Of the responders, 65.5% (167/255; 95% confidence interval (CI): 59.7-71.3) had provided anaesthesia to five or more patients with suspected UGIB during the previous six months. 32.9% (110/333; 95% CI: 27.9-38.0) had a local guideline for this procedure. Rapid sequence induction was part of the guideline for 71.8% (79/110; 95% CI: 63.4-80.2) in case of general anaesthesia (GA). The preferred choice of anaesthesia was GA with endotracheal intubation (56.2%; 187/333; 95% CI: 50.9-61.5).CONCLUSIONS: We found considerable variation in daily clinical practice of anaesthesia for patients undergoing EGD for suspected UGIB. The fact that anaesthesia for UGIB is a complex emergency procedure may underline the need for development of an international or at least a national guideline.FUNDING: The study received financial support from Karner's Foundation, Denmark.TRIAL REGISTRATION: not relevant.

AB - INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a common emergency. Currently, there are no agreed guidelines on the level of anaesthetic support required in patients undergoing acute esophago-gastro-duodendoscopy (EGD).METHODS: An online questionnaire comprising 19 questions was distributed to all members of the Danish Association of Anaesthesiology and Intensive Care (n = 1,418) and the Danish Society of Anaesthesiologists in Training (n = 566). The questions concerned clinical practice for anaesthesia care to patients undergoing EGD for suspected UGIB and availability of local guidelines.RESULTS: A total of 521 anaesthetists who had, on average, concluded medical school 14 years earlier (range: 9-27 years) answered the questionnaire. Of the responders, 65.5% (167/255; 95% confidence interval (CI): 59.7-71.3) had provided anaesthesia to five or more patients with suspected UGIB during the previous six months. 32.9% (110/333; 95% CI: 27.9-38.0) had a local guideline for this procedure. Rapid sequence induction was part of the guideline for 71.8% (79/110; 95% CI: 63.4-80.2) in case of general anaesthesia (GA). The preferred choice of anaesthesia was GA with endotracheal intubation (56.2%; 187/333; 95% CI: 50.9-61.5).CONCLUSIONS: We found considerable variation in daily clinical practice of anaesthesia for patients undergoing EGD for suspected UGIB. The fact that anaesthesia for UGIB is a complex emergency procedure may underline the need for development of an international or at least a national guideline.FUNDING: The study received financial support from Karner's Foundation, Denmark.TRIAL REGISTRATION: not relevant.

M3 - Journal article

C2 - 28975884

VL - 64

JO - Danish Medical Journal

JF - Danish Medical Journal

SN - 2245-1919

IS - 10

M1 - A5409

ER -