Abstract
A high proportion of the mortality and morbidity associated with endoscopic procedures
may be of cardiopulmonary origin. For this reason, the appropriate degree of monitoring
and prophylactic measures to be used in the sedated patient undergoing endoscopy has
become a topic of discussion during recent years. The development of myocardial ischaemia
during gastrointestinal endoscopy has traditionally been considered to be due to the
simultaneous arterial hypoxaemia; however, recent investigations have suggested that
tachycardia may be a more important pathogenic factor. No study has ever shown that
pulse oximetry monitoring or supplemental oxygen will reduce the morbidity or mortality
during gastrointestinal endoscopy. The current guidelines for monitoring and oxygen
therapy are therefore not supported by scientific data. There is a need for further
studies on the pathogenic mechanisms in myocardial ischaemia during endoscopy, and
the influence of hypoxaemia on the outcome after upper and lower endoscopy should
be clarified.
