Anesthesia for Urgent Gastroscopy in Cold Agglutinin Disease: A Case Report and Literature Review.

We present the case of a 76-year-old lady who underwent an emergency gastroscopy for suspected upper gastrointestinal bleeding on a background of cold agglutinin disease, a rare autoimmune haemolytic anaemia triggered by cold temperatures. Several pre-operative and intra-operative precautions were taken to minimise the risk of hypothermia. Sedation anaesthesia was used with midazolam and gradual titration of propofol with high-flow nasal cannulae to maintain oxygenation. The anaesthetic proceeded safely and without complications, and we compared our technique to the literature.