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Related Experiment Video

Updated: Apr 16, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
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Prophylactic tracheal intubation for upper GI bleeding: A meta-analysis.

Ashraf A Almashhrawi1, Rubayat Rahman1, Samuel T Jersak1

  • 1Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States.

World Journal of Meta-Analysis
|March 6, 2015
PubMed
Summary

Prophylactic endotracheal intubation in upper gastrointestinal bleeding patients undergoing endoscopy increases the risk of pneumonia. This meta-analysis found no significant difference in aspiration or mortality rates.

Keywords:
AspirationComplicationEndoscopyPneumoniaProphylactic endotracheal intubationUpper gastrointestinal bleeding

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Area of Science:

  • Gastroenterology
  • Pulmonology
  • Critical Care Medicine

Background:

  • Upper gastrointestinal bleeding (UGIB) is a common cause of hospital admissions, with endoscopy as the primary treatment.
  • Patients undergoing endoscopy for UGIB face risks including pulmonary aspiration.
  • Limited data exists on the efficacy of prophylactic endotracheal intubation in mitigating these risks.

Purpose of the Study:

  • To assess the utility of prophylactic endotracheal intubation in patients with upper gastrointestinal bleeding (UGIB) undergoing endoscopy.
  • To evaluate the impact of prophylactic intubation on aspiration, pneumonia, and mortality.

Main Methods:

  • A systematic literature search was conducted across multiple databases (Scopus, CINAHL, Cochrane, PubMed/Medline, Embase) and conference abstracts.
  • Included studies compared prophylactic intubation versus no intubation in UGIB patients prior to endoscopy.
  • Meta-analysis utilized Mantel-Haenszel and DerSimonian and Laird models to calculate odds ratios for key outcomes.

Main Results:

  • Four studies with 367 patients were included in the meta-analysis.
  • Pneumonia within 48 hours occurred in 14.9% of intubated patients versus 5.3% of non-intubated patients (P=0.02).
  • No statistically significant differences were observed in aspiration (P=0.11) or mortality (P=0.18) rates between the groups.

Conclusions:

  • Prophylactic endotracheal intubation in UGIB patients before endoscopy is associated with a higher incidence of pneumonia within 48 hours.
  • The procedure does not appear to significantly reduce aspiration or mortality risks.