Aspiration of Gastric Contents, Acute

Pulmonary response depends on the characteristics and amount of gastric contents aspirated

One of the most common causes of acute respiratory distress syndrome

May be catastrophic

Sometimes referred to as Mendelson syndrome

Abrupt onset of respiratory distress, with cough, wheezing, fever, and tachypnea

Crackles may be audible at the bases of the lungs

Hypoxemia may be noted immediately after aspiration occurs

Fever and leukocytosis are common even in the absence of infection

Patchy alveolar opacities in dependent lung zones, appear within a few hours

Radiographic features of bronchial obstruction may be observed if particulate food matter has been aspirated along with gastric acid

Hypotension secondary to alveolar capillary membrane injury and intravascular volume depletion is common

The more acidic the material, the greater the degree of chemical pneumonitis

Aspiration of pure gastric acid (pH < 2.5) causes

• Extensive desquamation of the bronchial epithelium

• Bronchiolitis

• Hemorrhage

• Pulmonary edema

Supplemental oxygen

Measures to maintain airway

Management of acute respiratory failure

Administer intravenous fluids for intravascular volume depletion

No evidence supports routine use of corticosteroids or prophylactic antibiotics

Management of secondary pulmonary infection depends on observed flora from tracheobronchial tree