Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 9-31: Pulmonary Aspiration Syndromes + Key Features Download Section PDF Listen +++ ++ 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 + Clinical Findings Download Section PDF Listen +++ ++ 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 + Diagnosis Download Section PDF Listen +++ ++ 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 + Treatment Download Section PDF Listen +++ ++ 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