Cardiorespiratory complications of digestive endoscopy not related to sedation.

Abstract

Although digestive endoscopy is considered to be a safe procedure, both the growing complexity of the techniques and the underlying diseases of patients increase the risk of adverse events during the procedure. Cardiorespiratory events are the most frequent complications, and can occur in patients with or without sedation, although they appear more often when the patient is sedated. The body's physiological response to stress is what causes these adverse events, which are generally mild and transient, although they can be serious. They are more frequent in patients with cardiopulmonary diseases, which logically increase risk. The autonomic nervous system, through its sympathetic and parasympathetic branches, is primarily responsible for these alterations. Patients with asthma or chronic obstructive pulmonary disease have a higher risk of hypoxemia, bronchospasm, and arrhythmia during the endoscopic procedure. Patients with arrhythmia and ischemic heart disease have a higher risk of myocardial ischemia and heart rhythm disturbances. The risk of adverse events during the procedure can be reduced by reviewing the patient's medical history along with a basic clinical examination before endoscopy. A brief interrogation about symptom control can also help the safety of endoscopy.