Bedside colonoscopy in intensive care units: indications, techniques, and outcomes

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Endoscopy

Background:

• Colonoscopy in critically ill patients is under-researched.
• The clinical context differs significantly from routine colonoscopy.
• Urgent colonoscopy aims to address specific critical care needs.

Purpose of the Study:

• To examine the role and effectiveness of urgent colonoscopy in intensive care unit (ICU) patients.
• To evaluate indications, procedures, and outcomes of colonoscopies performed at the bedside.

Main Methods:

• Retrospective review of a prospectively recorded ICU colonoscopy database.
• Analysis of patient data including indications, co-morbidities, sedation, bowel preparation, and outcomes.
• Assessment of colonoscopic intubation depth and completion rates.

Main Results:

• 41 patients underwent 49 bedside colonoscopies, primarily for ischemic colitis, colonic distension, or lower gastrointestinal hemorrhage.
• Most patients had major co-morbidities, with 28 on mechanical ventilation.
• Colonoscopy reached the cecum in 41% of cases; completion was hindered by poor preparation or stool in a significant number of patients.

Conclusions:

• Bedside colonoscopy is a valuable tool for diagnosing and managing acute lower gastrointestinal conditions in ICU settings.
• Despite challenges in critically ill patients, the procedure offers diagnostic and therapeutic benefits.