Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Abstract

AIM:To assess the adoption of Carbon dioxide (CO2) insufflation by endoscopists from various European countries, and its determinants. M E T H O D S :A s u r v e y w a s d i s t r i b u t e d t o 5 8 0 endoscopists attending a live course on digestive endoscopy. RESULTS:The response rate was 24.5%. Fewer than half the respondents (66/142, 46.5%) were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy, and 4.2% of respondents were actually using CO2 as the insufflation agent. Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice (84% and 49% of answers, respectively; two answers were permitted for this item). CONCLUSION:Based on this survey, adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional. A majority of endoscopists were not aware of this possibility, while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.

Meta‐analysis: the use of carbon dioxide insufflation vs. room air insufflation for gastrointestinal endoscopy

“…Thirty‐five abstracts appeared relevant and the full studies were assessed. Further 14 studies were rejected for being a meeting abstract without detailed information or crossover trial, having a nonrandomised control or no control, being a technique survey or animal experiment, involving peroral cholangioscopy or a barium enema, or being a clinical perspective review . Twenty‐one publications were deemed by both authors to be original research and to fit the search criteria.…”

“…As far as our knowledge goes, the vast majority of endoscopy facilities around the world still use air insufflations for endoscopic procedures. There may be some reasons for it: (i) The majority of endoscopists are not aware of the possibility that room air can be replaced by CO 2 for gut distension during endoscopy . (ii) This is also partly due to lack of CO 2 insufflators adequately tailored for GI endoscopy.…”

Carbon dioxide insufflation for colonoscopy: evaluation of gas volume, abdominal pain, examination time and transcutaneous partial CO2 pressure

“…Although CO 2 insufflation during a colonoscopy has been shown to be accompanied by relatively less pain than air insufflation, CO 2 insufflation has not been widely adopted [7,9]. The reluctance to use CO 2 as an insufflation agent is likely due to both an insufficient awareness by endoscopists that room air is replaceable with CO 2 as well as the fact that many hospitals are not equipped with a CO 2 insufflator in the endoscopy suite [7,9].…”

“…The reluctance to use CO 2 as an insufflation agent is likely due to both an insufficient awareness by endoscopists that room air is replaceable with CO 2 as well as the fact that many hospitals are not equipped with a CO 2 insufflator in the endoscopy suite [7,9]. Endoscopic CO 2 insufflators, such as CO 2 -efficient (E-Z-EM; Lake Success, NY) and the Olympus UCR (Olympus, Tokyo, Japan), are commercially available.…”

Prophylaxis of post-ERCP pancreatitis: a practice survey

“…15 Briefly, questionnaires were placed in bags distributed to course participants, and attendees were asked to deposit completed surveys in a dedicated box at the registration desk. Consent to participate in this study was inferred from voluntary completion of the survey.…”