Background
The knowledge of bedside diagnostic EUS in critically ill patients is limited.
Objective
To investigate the indications, feasibility, safety, and clinical utility of diagnostic
EUS in the intensive care unit (ICU).
Design
Retrospective.
Setting
Tertiary-care referral teaching hospital.
Patients
All consecutive patients who had EUS done in the ICU within a 6-year period.
Intervention
Bedside EUS and EUS-guided FNA.
Main Outcome Measurements
EUS indications, complications, and impact on management.
Results
A total of 64 EUS procedures were performed in 63 patients (38 men, 25 women; age
range 27-78 years); 1 patient underwent 2 separate EUS procedures. EUS was performed
while the patients were mechanically ventilated in 70% (45/64) of cases. Indications
for EUS included jaundice (n = 24), mass of unknown etiology (n = 25), unexplained
pancreatitis (n = 7), and staging of known cancer (n = 3). In 5 cases, EUS was used
as an alternative to other imaging modalities because of morbid obesity (n = 3) or
contraindication to intravenous contrast material (n = 2). Complications included
reversible oxygen desaturation (n = 4), nonsustained ventricular tachycardia (n =
1), and transient hypotension (n = 1). Overall, EUS influenced management in 97% (62/64)
of cases.
Limitations
Retrospective, single-center study.
Conclusion
ICU-based EUS can be performed with few intraprocedural complications and can be a
valuable diagnostic modality in the ICU setting. It appears to be particularly useful
for determining the etiology of jaundice, masses of unknown etiology, and pancreatitis.
It may have particular value as a diagnostic technique on selected patients with unstaged
cancer and when morbid obesity or the inability to use intravenous contrast material
precludes the use of other imaging modalities in the critically ill patient.
Abbreviations:
ASA (American Society of Anesthesiologists Physical Status Classification System), EUS-FNA (EUS-guided FNA), ICU (intensive care unit), MRI (magnetic resonance imaging)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 06, 2012
Accepted:
October 5,
2012
Received:
August 9,
2012
Footnotes
If you would like to chat with an author of this article, you may contact Dr Berzosa at [email protected]
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
© 2013 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
