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Aspiration of Gastric Contents
Inhalation of Gastric Contents as an External Cause of Morbidity and Mortality

Presentation

A case is presented of a 16-year-old girl with ectodermal dysplasia for whom dental surgery under general anaesthesia was planned. [ncbi.nlm.nih.gov]

[…] in the esophagus, the upper esophageal sphincter (UES) presents the next barrier to pulmonary aspiration. [mhmedical.com]

Entire Body System

  • Hypoxemia

    These findings usually included fever, tachypnea, diffuse rales, and serious hypoxemia. Cough, cyanosis, wheezing, and apnea were each seen in approximately one third of the cases. [ncbi.nlm.nih.gov]

    Pulmonary aspiration can present symptoms of wheezing, coughing, dyspnea, cyanosis, pulmonary edema, hypotension, and hypoxemia, which may progress rapidly to severe acute respiratory distress syndrome (ARDS). [kjccm.org]

    The CXR is mottled and the patient is prone to develop hypoxemia secondary to right to left intrapulmonary shunting. [quizlet.com]

    […] gastric tube (for example, a feeding tube ) may also increase the risk. [3] Consequences [ edit ] Particle-related [ edit ] Pulmonary aspiration of particulate matter may result in acute airway obstruction which may rapidly lead to death from arterial hypoxemia [en.wikipedia.org]

    […] difficulty, noisy breathing Chest pain Rapid heartbeat Low grade fever Weight loss Fatigue Blue coloring, especially lips and nail beds Blood-streaked mucus Increased mucus production Increased white blood cell production Tachypnea Tachycardia Transient hypoxemia [cme.ucsd.edu]

  • Falling

    Pulmonary consequences of gastric aspiration fall into three groups: (i) particle-related, (ii) acid-related and (iii) bacterial. [ispub.com]

Respiratoric

  • Cough

    Prevention Most people can prevent it by having a strong cough. Physiotherapy can help to develop and maintain the coughing muscles. [ada.com]

    Symptoms of aspiration include: Coughing, choking, wheezing, rapid breathing and bad breath. [healthcentral.com]

    Cough, cyanosis, wheezing, and apnea were each seen in approximately one third of the cases. Apena, shock, and early severe hypoxemia were particularly ominous events. [ncbi.nlm.nih.gov]

    In that case, most of the time you’ll be able to prevent this by coughing. Those who have impaired coughing ability, however, may not be able to. [healthline.com]

    In addition, any tiny amounts of inhaled fluid usually leads to a cough reflex which expels the fluid effectively without causing damage to the lungs. [news-medical.net]

  • Respiratory Distress

    Key Words: acute respiratory distress syndrome ; aspiration pneumonitis ; diffuse alveolar hemorrhage [kjccm.org]

    Worsening of infiltrates after initial improvement was associated with the development of bacterial pneumonia, the adult respiratory distress syndrome, and pulmonary embolism. [ncbi.nlm.nih.gov]

    Intubation is not required if there is no respiratory distress. [aast.org]

    Differential diagnosis Other causes of respiratory distress, including: Other causes of pneumonia. Bronchiolitis. Croup. Epiglottitis. Foreign body in respiratory tract. Asthma. Cardiovascular disease. [patient.info]

  • Hoarseness

    Pulmonary symptoms range from a subtle cough, wheezing, or hoarseness to severe dyspnea or asphyxiation. We discuss the mechanism of pulmonary disease caused by aspiration as well as the appropriate treatment. [link.springer.com]

    Symptoms of pediatric aspiration may include: Choking, coughing, or gagging while eating Weak sucking Fast or stopped breathing while feeding Hoarse voice or cry Noisy breathing or wheezing Slight fever after eating Chest discomfort or complaints of food [pedilung.com]

  • Rales

    These findings usually included fever, tachypnea, diffuse rales, and serious hypoxemia. Cough, cyanosis, wheezing, and apnea were each seen in approximately one third of the cases. [ncbi.nlm.nih.gov]

  • Stridor

    Bronchiectasis may follow. presentation of small particle partially obstructive aspiration is with dyspnoea, persistent coughing, wheeze, stridor and hypoxaemia non-obstructive particulate aspiration causes a clinical and radiological picture similar [aic.cuhk.edu.hk]

Gastrointestinal

  • Vomiting

    This article presents two incidents involving diving-related vomiting with associated aspiration of gastric contents. [ncbi.nlm.nih.gov]

    This manifests as reddish streaks of fresh blood in the vomit content. Further Reading What is Vomiting? Vomiting Mechanism Vomit Content Vomiting Causes Vomiting Social Implications [news-medical.net]

Cardiovascular

  • Cyanosis

    Cough, cyanosis, wheezing, and apnea were each seen in approximately one third of the cases. Apena, shock, and early severe hypoxemia were particularly ominous events. [ncbi.nlm.nih.gov]

    Pulmonary aspiration can present symptoms of wheezing, coughing, dyspnea, cyanosis, pulmonary edema, hypotension, and hypoxemia, which may progress rapidly to severe acute respiratory distress syndrome (ARDS). [kjccm.org]

    Clinically, this may be asymptomatic, or present as tachypnoea, bronchospasm, wheeze, cyanosis and respiratory insufficiency. [slideshare.net]

    […] sucking Fast or stopped breathing while feeding Hoarse voice or cry Noisy breathing or wheezing Slight fever after eating Chest discomfort or complaints of food coming back up or feeling stuck Recurring lung or airway infections Apnea, bradycardia, or cyanosis [pedilung.com]

    […] breathing Chest pain Rapid heartbeat Low grade fever Weight loss Fatigue Blue coloring, especially lips and nail beds Blood-streaked mucus Increased mucus production Increased white blood cell production Tachypnea Tachycardia Transient hypoxemia with cyanosis [cme.ucsd.edu]

  • Hypertension

    Signs and symptoms of aspiration^ Aspiration often produces 1. sudden severe bronchospasm, 2. coughing, 3. wheezing, 4. tachypnea, 5. dyspnea, and 5. cor pulmonale secondary to pulmonary hypertension. 6. [quizlet.com]

    Aspiration pneumonia Lung abscess Pulmonary hypertension Pulmonary tree damage Decline in arterial blood oxygen tension Damage to alveolar-capillary membrane Interstitial edema Intraalveolar hemorrhage Bronchospasm Empyma Atelectasis Hypoxia Decrease [cme.ucsd.edu]

    His past medical history included hypertension and diabetes. The patient’s neurologic exam revealed paraplegia and complete lack of sensation below T11 which was a dramatic change from 6 hours previous. [pocusjournal.com]

Psychiatrical

  • Withdrawn

    After planned endotracheal and nasogastric intubation for elective surgery, 20 participants had tracheal and gastric aspirates withdrawn. A blinded investigator tested samples for the presence of pepsin using the assay. [ncbi.nlm.nih.gov]

    One must be concerned in the individual with risk for aspiration, that if an enteral feeding tube is eventually recommended, the sensory stimulation associated with eating would be withdrawn. [ct.gov]

Neurologic

  • Seizure

    · Defined as the passage of material from the oropharynx into the tracheobronchial tree · Predisposing conditions include: § CNS disorders § Intoxication or drug overdose § Seizure disorders § Recent anesthesia § Swallowing disorders § Poor oral care [learningradiology.com]

    […] tract such as gastro-esophageal reflux, gastroparesis, bowel obstruction, and ileus Elderly and nursing home patients who have a high incidence of reflux disease, dysphagia, and poor oral hygiene Dysphagia from neurologic disorders including stroke, seizures [aast.org]

    The following are considered to be independent risk factors for aspiration pneumonia: Impaired consciousness: drug or alcohol misuse, general anaesthesia, seizures, sedation, acute stroke, central nervous system lesions, head injury. [patient.info]

    Most cases associated with predisposing factors (see “Risk Factors”) Risk Factors Reduced consciousness, alcoholism, seizures, general anesthesia, dementia/cognitive impairment, age >60 years, poor nutritional status, poor oral hygiene Choking incident [unboundmedicine.com]

    […] of the esophagus or GI tract (stricture, gastroesophageal reflux (return to the index for documents on reflux and gastrointestinal disorders)) Immobility Poor body and head alignment Vomiting Decreased respiratory function History of pneumonia Stroke Seizures [cme.ucsd.edu]

Treatment

Treatment Treatment depends on the severity of the aspiration. The aspirated objects or objects may need to removed by using a flexible camera to look at the windpipes. If pneumonia occurs, antibiotics might be given. [ada.com]

NM (nizatidine 150 + metoclopramide 10) Group C, F (famotidine 20 mg), and FM (famotidine 20 mg + metoclopramide 10) Group C,S (lafutidine 10), SD (lafutidine 10 + domperidone 10), and Group SM (lafutidine 10 + metoclopramide 10) Other Names: Drug treatment [clinicaltrials.gov]

Treatment from the outset by adrenocortical steroids or antimicrobial agents had no demonstrable effect on the outcome. [ncbi.nlm.nih.gov]

Treatment includes supplemental oxygen, steroids, or help from a breathing machine. Depending on the cause of chronic aspiration, you may require surgery. [healthline.com]

Larrain A, Carrasco J, Galleguillos J, Pope CE: Reflux treatment improves lung function in patients with intrinsic asthma (abstract). Gastroenterology 80 :1204, 1981 Google Scholar 12. [link.springer.com]

Prognosis

Patients with the most extensive radiographic abnormalities on initial studies tended to have the worst prognosis; however, mild early pulmonary infiltrates occasionally progressed to life-threatening abnormalities, and extensive initial involvement was [ncbi.nlm.nih.gov]

Treatment and prognosis differ by aspirated substance. Aspiration can cause lung inflammation (chemical pneumonitis), infection ( bacterial pneumonia or lung abscess ), or airway obstruction. [msdmanuals.com]

Prognosis This depends on the underlying cause, general well-being of the patient, presence of complications, speed of diagnosis and effective treatment. [patient.info]

Both community-acquired pneumonia (CAP) and hospital-acquired pneumonia have a worse prognosis if aspiration (defined by both clinical and radiologic features) is likely to be the inciting event ( 3 ). [unboundmedicine.com]

Etiology

Knight said these two etiologic agents have been shown to use different pathways in producing inflammatory lung injury. [buffalo.edu]

Etiology and Pathophysiology Aspiration pneumonia occurs when organisms dwelling in the oropharynx or stomach are introduced into the lungs in sufficient volume to cause clinical disease of infection. [unboundmedicine.com]

Epidemiology

Objectives To use the UK Obstetric Surveillance System (UKOSS) to describe the epidemiology, risk factors and outcomes of maternal pulmonary aspiration in pregnancy in the UK. [npeu.ox.ac.uk]

Epidemiology It is common. One study of elderly patients implicated aspiration pneumonia in 10% or cases of community-acquired pneumonia [ 1 ]. [patient.info]

Epidemiology Prevalence Prevalence data is difficult to assess given variations in the definition of aspiration pneumonia (radiographic, clinical, or bacteriologic classifications have all been used). [unboundmedicine.com]

Pathophysiology

We review the pathophysiology of each of these syndromes and discuss important diagnostic and therapeutic consequences. FULL TEXT [annals.org]

PATHOPHYSIOLOGY OF ASPIRATION Natural barriers to aspiration include the lower esophageal sphincter, the upper esophageal sphincter, and the intrinsic protective airway reflexes. [mhmedical.com]

Ongoing basic science and clinical research are crucial for understanding the pathophysiology of aspiration-induced lung injury and developing novel therapeutic strategies. [aast.org]

Etiology and Pathophysiology Aspiration pneumonia occurs when organisms dwelling in the oropharynx or stomach are introduced into the lungs in sufficient volume to cause clinical disease of infection. [unboundmedicine.com]

Prevention

The maximum tilt used in this study was not adequate to prevent aspiration in the sniffing position. [ncbi.nlm.nih.gov]

Prevention Most people can prevent it by having a strong cough. Physiotherapy can help to develop and maintain the coughing muscles. [ada.com]

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