[Endoscopy on the surgical intensive care unit].

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Endoscopic Procedures

Background:

• Gastrointestinal bleeding is a primary reason for endoscopy in intensive care units (ICUs).
• Critically ill patients frequently experience gastrointestinal motility disorders, increasing mortality risk.
• Other endoscopic interventions are crucial for managing diverse conditions in ICUs.

Purpose of the Study:

• To outline the various indications for endoscopy in the intensive care unit.
• To describe the peri-interventional and postinterventional management strategies.
• To highlight advanced endoscopic therapies for critical care.

Main Methods:

• Review of current literature on ICU endoscopy indications and management.
• Discussion of established endoscopic procedures like postpyloric feeding tube placement.
• Exploration of therapeutic endoscopy, including endoscopic vacuum therapy and decompression.

Main Results:

• Endoscopic vacuum therapy is the preferred treatment for esophageal and rectal anastomotic leakage.
• Endoscopic decompression for pseudo-obstruction is viable for cecal diameters >9-12 mm but carries perforation risks.
• Postpyloric feeding tube placement via endoscopy is a standard procedure.

Conclusions:

• Endoscopy offers critical therapeutic and diagnostic options in ICUs beyond bleeding management.
• Careful patient selection and management are essential for safe and effective endoscopic interventions in critical care.
• Advanced endoscopic techniques improve outcomes for specific conditions like anastomotic leaks and motility disorders.