Oxygen desaturation during endoscopy in the elderly

Arterial oxygen desaturation during oesophago-gastro duodenoscopy (OGD) is well recognised. It has been suggested that severe desaturation (greater than 7%) may predispose patients with cardiopulmonary disease and the elderly to cardiac arrhythmias. During OGD, of 106 elderly patients 26 developed ventricular and/or supraventricular ectopics, but these were not related to the degree of oxygen desaturation induced in this study. Apart from one episode of vasovagal syncope, which responded to intravenous atropine, no serious arrhythmias were recorded. Arterial oxygen desaturation during OGD was easily preventable with oxygen administration via nasal cannulae and was not associated with any adverse haemodynamic effects. Continuous cardiac and oxygen saturation monitoring should be routine practice in order to identify such problems.