ARTERIAL OXYGEN DESATURATION DURING NON-SEDATED DIAGNOSTIC UPPER GASTROINTESTINAL ENDOSCOPY IN PATIENTS WITH CIRRHOSIS

Oxygen saturation was studied with a pulse oximeter in 80 patients wit h cirrhosis (44 Pugh-Child's class A, 25 class B, and 11 class C) and 80 controls undergoing diagnostic esophagogastroduodenoscopy (EGD). No narcotic agent was used during the procedure. Baseline SaO(2) was sig nificantly lower in cirrhotics than in controls (97.7 +/- 1.0% versus 98.4 +/- 0.9%, p < 0.01). However, nadir SaO(2) during EGD was similar for controls and cirrhotics (94.7 +/- 3.0% versus 94.9 +/- 3.3%, NS). Significant hypoxia was found in 29 (36%) control patients: mild hypo xia (95% > nadir SaO(2) greater than or equal to 90%) in 22 patients a nd severe hypoxia (nadir SaO(2) < 90%) in 7. Similarly, significant hy poxia was noted in 28 (35%) cirrhotic patients: mild hypoxia in 21 and severe hypoxia in 7. The mean duration of significant hypoxia during total EGD time was also similar for controls and cirrhotics (7.4 +/- 6 .3% versus 9.2 +/- 10.7%, NS). When the degree of hypoxia during EGD w as correlated with the severity of liver disease, analysis of variance (ANOVA) failed to show a significant relationship between Pugh-Child' s class and nadir SaO(2) or duration of significant hypoxia during tot al EGD time. These results suggest that oxygen desaturation during EGD occurs both in cirrhotic patients and in controls. We therefore concl ude that a population of patients with cirrhosis does not have an incr eased risk of oxygen desaturation during non-sedated EGD.