Presentation
The purpose of this summary is present ability to perform prevention of aspiration of gastric contents of patients at risk for a difficult intubation and ventilation mask. [ijtra.com]
It was presented to emergency with symptoms of postprandial vomiting plenty flemosas content with bilious secretions, nausea and abdominal pain. Emergency bronchoscopy was key to the diagnosis and subsequent treatment. [scielo.org.bo]
Abstract Four cases of Mendelson's syndrome (acid pulmonary aspiration) are presented. They all demonstrate an acute diffuse alveolar filling pattern. This appearance is by no means specific. [ncbi.nlm.nih.gov]
Lung aspiration of acid gastric contents often results in initial nonsignificant lung damage; however, consistent hypoxemia is present. [amjcaserep.com]
Entire Body System
- Pain
Symptoms of carpal tunnel syndrome may include: Numbness, tingling, burning, and pain—primarily in the thumb and index, middle, and ring fingers Occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers Pain or tingling [mendelsonortho.com]
Fever, pleuritic chest pain, cough and dyspnea are common symptoms of pneumonia. [4] [explainmedicine.com]
It was presented to emergency with symptoms of postprandial vomiting plenty flemosas content with bilious secretions, nausea and abdominal pain. Emergency bronchoscopy was key to the diagnosis and subsequent treatment. [scielo.org.bo]
Continuing Education in Anaesthesia, Critical Care & Pain. 6 (6): 215–218. doi:10.1093/bjaceaccp/mkl048. ^ Enersen, OD. "Whonamedit – Mendelson's syndrome". Whonamedit? A dictionary of medical eponyms. Retrieved 2011-04-22. ^ Mendelson, CL (1946). [en.wikipedia.org]
- Collapse
Applies To Inhalation [aspiration] of stomach contents or secretions following anesthesia or other sedation in labor or delivery Mendelson's syndrome following anesthesia or other sedation in labor or delivery Pressure collapse of lung following anesthesia [icd9data.com]
X-ray of the chest shows soft patchy mottling scattered through the lung fields but no evidence of lung collapse. Postmortem examination of the lungs will show gross swelling of [jamanetwork.com]
Usual symptoms are sudden collapse, dyspnoea, cyanosis, and hypotension. [2] Air embolism In air embolism small volume air bubbles enter the blood vessels. [explainmedicine.com]
- Surgical Procedure
High risk is defined as these factors: Non-elective surgical procedure Light anaesthesia/unexpected response to stimulation Acute or chronic, upper or lower GI pathology Obesity Opioid medication Neurological disease, impaired conscious level, or sedation [findzebra.com]
High risk is defined as these factors:[2] Non-elective surgical procedure Light anaesthesia/unexpected response to stimulation Acute or chronic, upper or lower GI pathology Obesity Opioid medication Neurological disease, impaired conscious level, or sedation [wikizero.com]
This can happen in general anesthesia during surgical procedures, in other cases of unconsciousness, in muscle paralysis in the neck region, etc. High risk of aspiration occurs also in CPR. [health-tutor.com]
High risk is defined as these factors: [2] Non-elective surgical procedure Light anaesthesia/unexpected response to stimulation Acute or chronic, upper or lower GI pathology Obesity Opioid medication Neurological disease, impaired conscious level, or [popflock.com]
- Swelling
Recovery Immediately following surgery, you will be encouraged to elevate your hand above your heart and move your fingers to reduce swelling and prevent stiffness. You should expect some pain, swelling, and stiffness after your procedure. [mendelsonortho.com]
The itching, burning and swelling of my labia were simply unbearable. I have purchased several over-the-counter treatments, including Monistat cream to subside the symptoms. [es.slideshare.net]
The orofacial swelling is characterized by fissured, reddish-brown, swollen, nonpruritic lips or firm edema of the face. The facial palsy is indistinguishable from Bell's palsy. [ncbi.nlm.nih.gov]
Postmortem examination of the lungs will show gross swelling of [jamanetwork.com]
- Unconsciousness
CPR is performed in horizontal position in an unconscious patient and the repeated chest compressions may cause extrusion of gastric contents upward, where it is aspirated. [health-tutor.com]
It usually occurs when a person vomits while inebriated, stuporous from anesthesia, or unconscious, as during a seizure. [medical-dictionary.thefreedictionary.com]
ThesaurusAntonymsRelated WordsSynonymsLegend: Noun 1. aspiration pneumonia - inflammation of the lungs caused by inhaling or choking on vomitus; may occur during unconsciousness (anesthesia or drunkenness or seizure or cardiac arrest) Based on WordNet [thefreedictionary.com]
Respiratoric
- Aspiration
JAMA. 1967; 201: 51 Awe WC Fletcher WS Jacob SW The pathophysiology of aspiration pneumonitis. Surgery. 1966; 60: 232 Bannister WU Sattelaro AJ Otis RD Therapeutic aspects of aspiration pneumonitis in experimental animals. [americanjournalofsurgery.com]
aspiration in this patient. [bjoaonline.com]
The aspiration of stomach contents into the lungs during obstetric anesthesia. Amer. J. Obstet. Gynec., 52 : 191 (1946). Google Scholar 2. Teabeaut, J.R. Aspiration of gastric contents, experimental study. Amer, T. Path., 28 : 51 (1952). [link.springer.com]
The New England journal of medicine. 2019 Feb 14; [PubMed PMID: 30763196] [18] Marik PE, Aspiration pneumonitis and aspiration pneumonia. [statpearls.com]
Gastric aspiration: prevention and treatment. Cli Anesthesial 1986:4-47. Bond VK, Stoelting RK, Gupta CD. Pulmonary aspiration syndrome after inhalation of gastric fluid containing antacids. Anesthesiology 1979:51-452. Vanner RG, Goodman NW. [medigraphic.com]
- Pneumonia
The lung damage and pneumonias can be visualized by chest X-ray or computed tomography. [health-tutor.com]
Safety and Effect of Metoclopramide to Prevent Pneumonia in Patients With Stroke Fed via Nasogastric Tubes Trial. Stroke. 2014 Dec 16. [Medline]. Adnet F, Baud F. Relation between Glasgow Coma Scale and aspiration pneumonia. [medscape.com]
Aspiration pneumonia--Mendelson Syndrome; a Review. Ir Med J. 1984;77(8):252-5. PubMed PMID: 6384133. TY - JOUR T1 - Aspiration pneumonia--Mendelson syndrome; a review. [unboundmedicine.com]
American journal of obstetrics and gynecology. 1955 Oct; [PubMed PMID: 13258675] [17] Mandell LA,Niederman MS, Aspiration Pneumonia. [statpearls.com]
What Causes Aspiration Pneumonia? My father is hospitalized with aspiration pneumonia. What causes this? A. [medical-dictionary.thefreedictionary.com]
- Respiratory Distress
Hypotension Respiratory distress can cause hypotension. Hypotension Respiratory distress can cause hypotension. Pulmonary edema Pulmonary crackles are indicative of pulmonary edema. [medicaljoyworks.com]
Mendelson's syndrome complicated by acute respiratory distress syndrome Vasyl Zaiachuk, Nazar Pryimak, Mariia Zaiachuk. [bibliomed.org]
distress, and bacterial pneumonia. [radiologykey.com]
Acute respiratory distress syndrome Other names Respiratory distress syndrome (RDS), adult respiratory distress syndrome, shock lung Chest x-ray of person with severe ARDS demonstrating widespread "ground-glass" appearing opacities in both lungs Specialty [en.wikipedia.org]
It is marked by bronchoconstriction and destruction of the tracheal mucosa, progressing to a syndrome resembling acute respiratory distress syndrome. Also called pulmonary acid aspiration syndrome. Patient discussion about Mendelson's syndrome Q. [medical-dictionary.thefreedictionary.com]
- Sputum
There is minimal sputum. The condition often follows anaesthesia when the gag reflex is depressed, particularly during pregnancy. A secondary bacterial infection may develop - indicated by sputum, persistent fever, leukocytosis, and sepsis. [gpnotebook.co.uk]
[…] after aspiration) and within hours the patient may become tachypneic hypoxic febrile Other signs include bronchospasm with need for increasing ventilation pressure bronchial hypersecretion pulmonal vasoconstriction cyanosis Usually there is minimal sputum [radiopaedia.org]
There is a bloody, frothy sputum and marked pulmonary congestion. A very high pulse and respiratory rate are common, and gross pulmonary edema may supervene, with a rapidly deteriorating course resulting in death from cardiac failure. [jamanetwork.com]
- Dyspnea
Such features may include cyanosis, dyspnea, fever, pulmonary wheeze, crepitant rales, rhonchi, and tachycardia with a low blood pressure. Decreased arterial oxygen tension is also likely to be evident. [findzebra.com]
Two to five hours after aspiration there is a dramatic onset of cyanosis, dyspnea, tachycardia, and shock. 2 Examination of the patient shows no localized signs of lung disease but generalized adventitious sounds and bronchospasm. [jamanetwork.com]
A choking patient was admitted with dyspnea, cyanosis, and loss of consciousness, which initially improved after suction of the airways. [scielo.br]
Gastrointestinal
- Vomiting
Anaesthesia. 1980; 35: 641-650 Holmes JM Prevention of inhaled vomit during obstetric anaesthesia. 1956; 63: 239-240 Howard FA Sharp DS Effect of metoclopramide on gastric emptying during labour. [midwiferyjournal.com]
What is the difference between regurgitation and vomiting? 8/24/2014 4 5. [slideshare.net]
Classically, there is a history of vomiting after inhalation anesthesia, either during the operation or in the early postoperative period. [jamanetwork.com]
Cardiovascular
- Cyanosis
Cyanosis Patients can develop cyanosis due to reduced oxygenation, as a result of respiratory distress. Cyanosis Patients can develop cyanosis due to reduced oxygenation, as a result of respiratory distress. [medicaljoyworks.com]
[…] syndrome develops rapidly (2-12 hours after aspiration) and within hours the patient may become tachypneic hypoxic febrile Other signs include bronchospasm with need for increasing ventilation pressure bronchial hypersecretion pulmonal vasoconstriction cyanosis [radiopaedia.org]
Such features may include cyanosis, dyspnea, fever, pulmonary wheeze, crepitant rales, rhonchi, and tachycardia with a low blood pressure. Decreased arterial oxygen tension is also likely to be evident. [findzebra.com]
Two to five hours after aspiration there is a dramatic onset of cyanosis, dyspnea, tachycardia, and shock. 2 Examination of the patient shows no localized signs of lung disease but generalized adventitious sounds and bronchospasm. [jamanetwork.com]
- Tachycardia
Such features may include cyanosis, dyspnea, fever, pulmonary wheeze, crepitant rales, rhonchi, and tachycardia with a low blood pressure. Decreased arterial oxygen tension is also likely to be evident. [findzebra.com]
Two to five hours after aspiration there is a dramatic onset of cyanosis, dyspnea, tachycardia, and shock. 2 Examination of the patient shows no localized signs of lung disease but generalized adventitious sounds and bronchospasm. [jamanetwork.com]
- Heart Failure
Severe acute pulmonary hypertension causes acute right heart failure. [2,3] Obstructive lung disease Patients who are already diagnosed to have asthma, chronic bronchitis and cystic fibrosis can develop exacerbation of the symptoms during pregnancy. [ [explainmedicine.com]
CONGESTIVE HEART FAILURE Congestive heart failure is another common EMS response with varied patient presentation. [emsworld.com]
Drugs: bronchodilators, diuretics, heart failure therapy, etc. Physiotherapy, including techniques to promote drainage. Treatment of other complications if and when they arise. [patient.info]
Musculoskeletal
- Contusion
Worldwide, severe sepsis is the most common trigger causing ARDS.[29] Other triggers include mechanical ventilation, sepsis, pneumonia, Gilchrist's disease, drowning, circulatory shock, aspiration, trauma—especially pulmonary contusion—major surgery, [en.wikipedia.org]
Neurologic
- Confusion
Roentgenograms show a classic patchy infiltrate on the involved areas which is easily confused with signs of pulmonary edema. [americanjournalofsurgery.com]
You are confused or cannot think clearly. You have more trouble breathing, or your breathing seems faster than normal. When should I contact my healthcare provider? You have a fever. Your symptoms are not better after 2 or 3 days of treatment. [drugs.com]
Although molecular genetic testing is useful to confirm the clinical diagnosis, the classic phenotype should not be confused with other syndromes. [rarediseases.org]
Due to these symptoms Mendelson’s Syndrome can be confused withbronchial asthmaattack. The pathology has 3 stages: 1. Cough, shortness of breath, cyanosis of the skin, tachycardia, lowering blood pressure. 2. [world-science.ru]
The choice of antibiotic is confused by conflicting evidence about the organisms responsible for infection, the poor yield from cultures in clinical practice and the lack of data comparing antibiotic regimens. [nps.org.au]
- Altered Mental Status
SIGNS AND SYMPTOMS (IMMEDIATELY POST-ASPIRATION) Altered mental status Evidence of recent vomiting Abnormal respiratory sounds (including rhonchi, gurgling, wheezing and diminished sounds). [emsworld.com]
Physical examination findings… Egophony and pectoriloquy Decreased breath sounds Pleural friction rub Altered mental status Hypoxemia Hypotension (in septic shock) 29. [slideshare.net]
Reassess the need for intubation on a frequent basis depending on the patient’s oxygenation, the patient's mental status, signs of increased work of breathing, or impending respiratory failure. [emedicine.medscape.com]
- Agitation
The diagnosis is readily established by the rapid onset of acute pulmonary symptoms with tachycardia and agitation in the postoperative period which are accompanied by a fall in arterial oxygen tension with preservation of normal or low carbon dioxide [americanjournalofsurgery.com]
Workup
X-Ray
- Atelectasis
Plain film and CT may depict fleeting infiltrates ( which do not last more than 1 or 2 days), atelectasis and non-cardiac lung edema. cardiac failure amniotic fluid embolism in chronic state may mimc a lung mass History and etymology It is named after [radiopaedia.org]
J Obstet Gynaec Brit Emp. 1955; 62: 509 Hamilton WK Atelectasis, pneumothorax, and aspiration as postoperative complications. Anesthesiology. 1961; 22: 708 Johnson H Pulmonary aspiration of gastric acid: Mendelson's syndrome. [americanjournalofsurgery.com]
Radiographic features Plain film and CT may depict fleeting infiltrates (which do not last more than 1 or 2 days), atelectasis and non-cardiac lung edema. [pacs.de]
[…] gastric contents into the lungs causing chemical pneumonitis by the passage of toxic substances the lower respiratory tract.The clinical picture is characterized by hypoxemia, dyspnea, bronchospasm, tachypnea, pulmonary edema, hypotension, cyanosis, and atelectasis [scielo.org.bo]
Treatment
JAMA. 1961; 176: 229 Haussman W Lunt RL Problem of treatment of peptic aspiration pneumonia following obstetric anesthesia (Mendelson's syndrome). [americanjournalofsurgery.com]
Surgical Treatment If nonsurgical treatment does not relieve your symptoms after a period of time, your doctor may recommend surgery. [mendelsonortho.com]
Proper treatment is essential because of the high morbidity and mortality involved. For Mendelson's syndrome occurs in a patient of 89 years of age due to Alzheimer's disease, a neurodegenerative disorder. [scielo.org.bo]
Prognosis
Frequent infectious complications, often with anaerobic microbes, are deciding factors in the prognosis. Artificial ventilation with positive pressure (sometimes continuous) is often necessary. [pubmed.ncbi.nlm.nih.gov]
Treatment and prognosis It is benign self-limiting condition, and the natural history is for the thrombosed vein to recanalize and for clinical symptoms to resolve gradually (~ 6 weeks). [radiopaedia.org]
Diffuse interstitial pulmonary fibrosis.[10] Prognosis The mortality can be as high as 60%. [patient.info]
Etiology
The etiologic agents is believed to be aspiration of acidic stomach contents, other compounds, e.g. bile, may also play a role. [radiopaedia.org]
Four representative cases are presented with roent-genographic documentation to illustrate the etiology, pathophysiology, and clinical course. [americanjournalofsurgery.com]
English: BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology [decs.bvs.br]
Etiology Aspiration or inhalation of particulate matter, fluids, or secretions from the stomach and/or oropharynx into the lungs may result in any of four different clinical syndromes: (1) chemical pneumonia (CP), aspiration of gastric acid and contents [radiologykey.com]
Abstract The Melkersson-Rosenthal syndrome is a rare disorder of unknown etiology characterized by a triad of recurrent orofacial swelling, relapsing facial paralysis, and fissured tongue. Exacerbations and recurrences are common. [ncbi.nlm.nih.gov]
Epidemiology
67(66) Allowable Qualifiers English: BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]
The data of X-ray examination somewhat resembled the disseminated process, and therefore in some cases were interpreted as a case of the firstly diagnosed pulmonary tuberculosis (FDPTB), and later as viral and bacterial pneumonia due to the epidemiological [bibliomed.org]
Google Scholar | Crossref | Medline | ISI WING, L. & GOULD, J. (1979) 'Severe Impairments of Social Interaction and Associated Abnormalities in Children: Epidemiology and Classification', Journal of Autism and Childhood Schizophrenia 9: 11-29. [journals.sagepub.com]
British Medical Research Council Pneumoconiosis Research Unit, Penarth, formerly Scientific Staff, British Medical Research Council Epidemiology Unit University of the West Indies West Indies [link.springer.com]
(Epidemiology) The incidence has been dropping due to improved anaesthetic practice, but there are concerns that the obesity epidemic may increase the risk (see 'Conditions or circumstances increasing risk', below).[6] One registry published data from [patient.info]
Pathophysiology
Four representative cases are presented with roent-genographic documentation to illustrate the etiology, pathophysiology, and clinical course. [americanjournalofsurgery.com]
The author describes the actual mechanisms by which Metabolic Syndrome progresses and causes damage in the body, including the action of insulin and the pathophysiology of insulin resistance. [elsevier.com]
OBJECTIVES Review pathophysiology of four pulmonary problems Discuss prehospital management of these patient groups This article reviews four different pulmonary problems, the pathophysiology behind them and current treatment. [emsworld.com]
Br J Anaesth, 40(6): 408-14 [ EČ ][ GS ] Awe, W.C., Fletcher, W.S., Jacob, S.W. (1966) The pathophysiology of aspiration pneumonitis. [scindeks.ceon.rs]
The pathophysiology of aspiration pneumonitis. Surgery, 60 : 232 (1966). Google Scholar 5. Hamelberc, W. & Bosomwohth, P.P. Aspiration pneumonitis, experimental and clinical observations. Anesth. & Analg., 43 : 669 (1966). Google Scholar 6. [link.springer.com]
Prevention
Another approach to the prevention of the acid aspiration (Mendelson's) syndrome. [midwiferyjournal.com]
Mechanisms of regurgitation and its prevention with cricoid pressure. Int J Obstet Anesth 1993;2:207-215. Vanner RG. Gastro-esophageal reflux and regurgitation during general anaesthesia for termination of pregnancy. [medigraphic.com]
Clinical and experimental investigations into the prevention of the acid aspiration syndrome (Mendelson’s syndrome). University of Cape Town. Brock-Utne, J. G. (1988). [open.uct.ac.za]
In theory, NGT is placed before the induction to prevent aspiration, but currently, there is no evidence supporting its routine placement for aspiration prevention.[3] Suspicion of aspiration was confirmed by persistent hypoxia, high airway pressure, [bjoaonline.com]
Prevention of aspiration remains the most important aim and there appears to be consensus around the world that preventative measures should be used more.[3, 4, 5] Pathophysiology[5] If aspirated material is sufficiently acid (pH lower than 2.5, which [patient.info]