ArticleBMC gastroenterology2025
Prophylactic endotracheal intubation prior to emergency endoscopy for acute esophagogastric variceal hemorrhage: a retrospective single center study.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- [Emphasizing the precise application of emergency endoscopy in the treatment of portal hypertensive bleeding in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Comparison of first-attempt endoscope insertion success between LMAIndian journal of anaesthesia · 2026Article
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3 authors.
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Abstract
backgroundProphylactic endotracheal intubation (PEI) is widely performed before emergency endoscopy in patients with acute esophagogastric variceal bleeding (AEVB). However, its safety and benefits remain controversial. This study aims to evaluate the efficacy of PEI in patients with AEVB and the appropriate extubation time.
methodsPatients with AEVB and underwent emergency endoscopy at The First Affiliated Hospital (04/2011-09/2023) were included and divided into PEI and non-PEI groups. Clinical outcomes included cardiopulmonary complications, incidence of automatic discharge or in-hospital death, hospital and intensive care unit (ICU) length of stay (LOS), and rebleeding rate in one month. Extubation time in patients with PEI was also analyzed.
resultsThree patients had massive aspiration without PEI. Among 141 patients, 97 (68.8%) received PEI. Pneumonia and pulmonary edema were more frequent in the PEI group (42.3% vs. 25.0%; OR = 2.20, 95% CI: 1.00-4.86; P = 0.049; 26.8% vs. 6.8%; OR = 5.00, 95% CI: 1.42-17.55; P = 0.007), and the ICU LOS was also longer (P<0.001). Among patients with PEI, 29 (29.9%) patients were extubated within 24 h, and had a lower incidence of acute respiratory distress syndrome (ARDS) (4.4% vs. 17.2%, P = 0.049; adjusted P = 0.123), lower automatic discharge or in-hospital death rate (2.9% vs. 20.7%, P = 0.008), shorter ICU and hospital LOS (P<0.001).
conclusionPEI prior to emergency endoscopy may not protect patients with AEVB from cardiopulmonary complications or improve their prognosis, but it may prevent severe fatal aspiration. And early extubation appears to be associated with better clinical outcomes.
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