Navigating gastrointestinal endoscopy challenges in the intensive care unit: A mini review

Abstract

Patients in the intensive care unit (ICU) may need bedside endoscopy for gastrointestinal (GI) emergencies. Conducting endoscopy in the ICU for critically ill patients needs special consideration. This mini review focuses on indications for bedside endoscopes, including GI bleeding, volvulus, and bowel obstruction. It explains the risks associated with urgent endoscopies in critical patients and outcomes. Hemodynamic instability, coagulopathy, and impaired mucosal visualization are important considerations before bedside endoscopy. It also discusses the anesthesia considerations for non-operating room anesthesia. Multidisciplinary collaboration, meticulous patient selection, and procedural optimization help mitigate risks and maximize procedural success.

Keywords: Endoscopy; Critical care; Intensive care; Colonoscopy; Anticoagulation; Bleeding

Core Tip: Bedside endoscopies are commonly practiced in intensive care unit for gastrointestinal emergencies and when patients cannot be transported outside the critical care unit for various indications. Consideration for multiorgan dysfunction and acuity of presentation is needed when planning bedside endoscopies. The present mini review underscores the importance of careful patient selection, timely implementation, and interdisciplinary cooperation in the management of potential hazards, including hemodynamic instability, coagulopathy, and compromised mucosal.