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Pulmonary Aspiration: An Update

Pulmonary Aspiration: An Update Abstract • Pulmonary aspiration of foreign material occurs in many situations. The morbidity of pulmonary aspiration is astounding; even more staggering is the mortality of massive aspiration of gastric contents. Bewilderment exists among most physicians concerning the treatment of this lethal event. The use of corticosteroids in pulmonary aspiration has received much attention and no data exist to advocate their continued employment. Knowledge of the bacteriology of aspiration has resulted in more judicious use of antimicrobial agents. The most significant advance in the treatment of pulmonary aspiration has been the development of positive end-expiratory pressure as an adjunct to mechanical ventilation. Pulmonary aspiration in hospitalized patients is an entirely preventable disease. All physicians must be made aware of the multitude of instances in which aspiration may occur if any hope of averting this disaster exists. (Arch Surg 112:1192-1197, 1977) References 1. Heimlich HJ: A lifesaving maneuver to prevent food choking . JAMA 234:398-402, 1975.Crossref 2. Heimlich HJ: Pop goes the cafe-coronary . Emergency Med 6:154-156, 1974. 3. Cameron JL, Zuidema GD: Aspiration pneumonia-magnitude and frequency of the problem . JAMA 219:1194-1196, 1972.Crossref 4. Arms RA, Dines DE, Tinstman TC: Aspiration pneumonia . Chest 65:136-139, 1974.Crossref 5. Awe WC, Fletcher WS, Jacob SW: The pathophysiology of aspiration pneumonitis . Surgery 60:232-239, 1966. 6. Dines DE, Titus JL, Sessler AD: Aspiration pneumonitis . Mayo Clin Proc 45:347-360, 1970. 7. Cameron JL, Mitchell WH, Zuidema GL: Aspiration pneumonia: Clinical outcome following documented aspiration . Arch Surg 106:49-52, 1973.Crossref 8. Graff TD, Phillips OC, Benson DW, et al: Baltimore anesthesia study committee: Factors in pediatric anesthesia mortality . Anesth Analg 43:407-414, 1964. 9. Cameron JL, Anderson RP, Zuidema GL: Aspiration pneumonia: A clinical and experimental review . J Surg Res 7:44, 1967.Crossref 10. Mendelson CL: The aspiration of stomach contents into the lungs during obstetric anesthesia . Am J Obstet Gynecol 52:191-205, 1946. 11. Maier HC, Schwartz SI: Wall, pleura, lung, and mediastinum , in Schwartz SI, Lillehei RC, Shires GT, et al (eds): Principles of Surgery . New York, McGraw-Hill Book Co Inc, 1974, pp 633-634. 12. Berson WB, Adriani J: "Silent" regurgitation and aspiration during anesthesia . Anesthesiology 15:644-649, 1954.Crossref 13. Cameron JL, Reynolds J, Zuidema GL: Aspiration in patients with tracheostomies . Surg Gynecol Obstet 136:68-70, 1973. 14. Conn HO: Hazards attending the use of esophageal tamponade . N Engl J Med 259:701-707, 1958.Crossref 15. Swann HG, Spafford NR: Body salt and water changes during fresh and sea water drowning . Tex Rep Biol Med 9:356-383, 1951. 16. Teabeaut JR: Aspiration of gastric contents: Experimental study . Am J Pathol 28:51-58, 1952. 17. Greenfield LJ, Singleton RP, McCaffree DR, et al: Pulmonary effects of experimental graded aspiration of hydrochloric acid . Ann Surg 170:74-86, 1969.Crossref 18. Cameron JL, Caldini P, Toung JK, et al: Aspiration pneumonia: Physiologic data following experimental aspiration . Surgery 72:238-245, 1972. 19. Hamelberg WV, Bosomworth PP: Aspiration pneumonitis . Spring-field, Ill, Charles C Thomas Publisher, 1968. 20. Bartlett JG, Gorbach SL: The triple threat of aspiration pneumonitis . Chest 68:560-566, 1975.Crossref 21. Toung JK, Bordos D, Benson DW, et al: Aspiration pneumonia: Experimental evaluation of albumin and steroid therapy . Ann Surg 183:179-184, 1976.Crossref 22. Ribaudo CA, Grace WJ: Pulmonary aspiration . Am J Med 50:510-520, 1971.Crossref 23. Tinstman TC, Dines DE, Arms RA: Post-operative aspiration pneumonia . Surg Clin North Am 53:859-862, 1973. 24. Bynum LJ, Pierce AL: Pulmonary aspiration of gastric contents . Am Rev Respir Dis 114:1129-1136, 1976. 25. Aldrete JA, Liem St, Carrow DJ: Pulmonary aerobic bacterial flora after aspiration pneumonitis . J Trauma 15:1014-1020, 1975.Crossref 26. Bartlett JG, Gorbach SL: Treatment of aspiration pneumonia and primary lung abscess: Penicillin G vs clindamycin . JAMA 234:935-937, 1975.Crossref 27. Taylor G, Pryse-Davis J: Evaluation of endotracheal steroid therapy in acid pulmonary aspiration syndrome (Mendelson's syndrome) . Anesthesiology 29:17-21, 1968.Crossref 28. Schmidt GB: Prophylaxis of pulmonary complications following abdominal surgery, including atelectasis, ARDS, and pulmonary embolism . Surg Ann 9:29-43, 1977. 29. Chapman RL, Modell JH, Ruiz BC, et al: Effect of continuous positive pressure, ventilation and steroids on aspiration of hydrochloric acid (pH 1.8) in dogs . Anesth Analg 53:556-562, 1974. 30. Ruiz BC, Calderwood HW, Modell JH, et al: Effect of ventilatory patterns on arterial oxygenation after near drowning with fresh water: A comparative study in dogs . Anesth Analg 52:570-576, 1973. 31. Modell JH, Calderwood HW, Ruiz BC, et al: Effects of ventilatory patterns on arterial oxygenation after near drowning in sea . Anesthesiology 40:376-384, 1974.Crossref 32. Lawson DW, DeFalco AJ, Phelps JA, et al: Corticosteroids as treatment for aspiration of gastric contents: An experimental study . Surgery 59:845-852, 1966. 33. Chapman RL, Downs JB, Modell JH, et al: The ineffectiveness of steroid therapy in treating aspiration of hydrochloric acid . Arch Surg 108:858-861, 1974.Crossref 34. Burgess GE: Antacids for obstetric patients . Am J Obstet Gynecol 123:577-581, 1975. 35. Taylor G, Pryse-Davis J: The prophylactic use of antacids in the prevention of the acid-pulmonary aspiration syndrome (Mendelson's Syndrome) Lancet 1:288-292, 1966.Crossref 36. Salem MR, Wong AY, Mani M, et al: Premedicant drugs and gastric juice pH and volume in pediatric patients . Anesthesiology 44:216-219, 1976.Crossref 37. McCormick PW: Immediate care after aspiration of vomit . Anaesthesia 30:658-665, 1975.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Pulmonary Aspiration: An Update

Archives of Surgery , Volume 112 (10) – Oct 1, 1977

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Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1977.01370100046009
Publisher site
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Abstract

Abstract • Pulmonary aspiration of foreign material occurs in many situations. The morbidity of pulmonary aspiration is astounding; even more staggering is the mortality of massive aspiration of gastric contents. Bewilderment exists among most physicians concerning the treatment of this lethal event. The use of corticosteroids in pulmonary aspiration has received much attention and no data exist to advocate their continued employment. Knowledge of the bacteriology of aspiration has resulted in more judicious use of antimicrobial agents. The most significant advance in the treatment of pulmonary aspiration has been the development of positive end-expiratory pressure as an adjunct to mechanical ventilation. Pulmonary aspiration in hospitalized patients is an entirely preventable disease. All physicians must be made aware of the multitude of instances in which aspiration may occur if any hope of averting this disaster exists. (Arch Surg 112:1192-1197, 1977) References 1. Heimlich HJ: A lifesaving maneuver to prevent food choking . JAMA 234:398-402, 1975.Crossref 2. Heimlich HJ: Pop goes the cafe-coronary . Emergency Med 6:154-156, 1974. 3. Cameron JL, Zuidema GD: Aspiration pneumonia-magnitude and frequency of the problem . JAMA 219:1194-1196, 1972.Crossref 4. Arms RA, Dines DE, Tinstman TC: Aspiration pneumonia . Chest 65:136-139, 1974.Crossref 5. Awe WC, Fletcher WS, Jacob SW: The pathophysiology of aspiration pneumonitis . Surgery 60:232-239, 1966. 6. Dines DE, Titus JL, Sessler AD: Aspiration pneumonitis . Mayo Clin Proc 45:347-360, 1970. 7. Cameron JL, Mitchell WH, Zuidema GL: Aspiration pneumonia: Clinical outcome following documented aspiration . Arch Surg 106:49-52, 1973.Crossref 8. Graff TD, Phillips OC, Benson DW, et al: Baltimore anesthesia study committee: Factors in pediatric anesthesia mortality . Anesth Analg 43:407-414, 1964. 9. Cameron JL, Anderson RP, Zuidema GL: Aspiration pneumonia: A clinical and experimental review . J Surg Res 7:44, 1967.Crossref 10. Mendelson CL: The aspiration of stomach contents into the lungs during obstetric anesthesia . Am J Obstet Gynecol 52:191-205, 1946. 11. Maier HC, Schwartz SI: Wall, pleura, lung, and mediastinum , in Schwartz SI, Lillehei RC, Shires GT, et al (eds): Principles of Surgery . New York, McGraw-Hill Book Co Inc, 1974, pp 633-634. 12. Berson WB, Adriani J: "Silent" regurgitation and aspiration during anesthesia . Anesthesiology 15:644-649, 1954.Crossref 13. Cameron JL, Reynolds J, Zuidema GL: Aspiration in patients with tracheostomies . Surg Gynecol Obstet 136:68-70, 1973. 14. Conn HO: Hazards attending the use of esophageal tamponade . N Engl J Med 259:701-707, 1958.Crossref 15. Swann HG, Spafford NR: Body salt and water changes during fresh and sea water drowning . Tex Rep Biol Med 9:356-383, 1951. 16. Teabeaut JR: Aspiration of gastric contents: Experimental study . Am J Pathol 28:51-58, 1952. 17. Greenfield LJ, Singleton RP, McCaffree DR, et al: Pulmonary effects of experimental graded aspiration of hydrochloric acid . Ann Surg 170:74-86, 1969.Crossref 18. Cameron JL, Caldini P, Toung JK, et al: Aspiration pneumonia: Physiologic data following experimental aspiration . Surgery 72:238-245, 1972. 19. Hamelberg WV, Bosomworth PP: Aspiration pneumonitis . Spring-field, Ill, Charles C Thomas Publisher, 1968. 20. Bartlett JG, Gorbach SL: The triple threat of aspiration pneumonitis . Chest 68:560-566, 1975.Crossref 21. Toung JK, Bordos D, Benson DW, et al: Aspiration pneumonia: Experimental evaluation of albumin and steroid therapy . Ann Surg 183:179-184, 1976.Crossref 22. Ribaudo CA, Grace WJ: Pulmonary aspiration . Am J Med 50:510-520, 1971.Crossref 23. Tinstman TC, Dines DE, Arms RA: Post-operative aspiration pneumonia . Surg Clin North Am 53:859-862, 1973. 24. Bynum LJ, Pierce AL: Pulmonary aspiration of gastric contents . Am Rev Respir Dis 114:1129-1136, 1976. 25. Aldrete JA, Liem St, Carrow DJ: Pulmonary aerobic bacterial flora after aspiration pneumonitis . J Trauma 15:1014-1020, 1975.Crossref 26. Bartlett JG, Gorbach SL: Treatment of aspiration pneumonia and primary lung abscess: Penicillin G vs clindamycin . JAMA 234:935-937, 1975.Crossref 27. Taylor G, Pryse-Davis J: Evaluation of endotracheal steroid therapy in acid pulmonary aspiration syndrome (Mendelson's syndrome) . Anesthesiology 29:17-21, 1968.Crossref 28. Schmidt GB: Prophylaxis of pulmonary complications following abdominal surgery, including atelectasis, ARDS, and pulmonary embolism . Surg Ann 9:29-43, 1977. 29. Chapman RL, Modell JH, Ruiz BC, et al: Effect of continuous positive pressure, ventilation and steroids on aspiration of hydrochloric acid (pH 1.8) in dogs . Anesth Analg 53:556-562, 1974. 30. Ruiz BC, Calderwood HW, Modell JH, et al: Effect of ventilatory patterns on arterial oxygenation after near drowning with fresh water: A comparative study in dogs . Anesth Analg 52:570-576, 1973. 31. Modell JH, Calderwood HW, Ruiz BC, et al: Effects of ventilatory patterns on arterial oxygenation after near drowning in sea . Anesthesiology 40:376-384, 1974.Crossref 32. Lawson DW, DeFalco AJ, Phelps JA, et al: Corticosteroids as treatment for aspiration of gastric contents: An experimental study . Surgery 59:845-852, 1966. 33. Chapman RL, Downs JB, Modell JH, et al: The ineffectiveness of steroid therapy in treating aspiration of hydrochloric acid . Arch Surg 108:858-861, 1974.Crossref 34. Burgess GE: Antacids for obstetric patients . Am J Obstet Gynecol 123:577-581, 1975. 35. Taylor G, Pryse-Davis J: The prophylactic use of antacids in the prevention of the acid-pulmonary aspiration syndrome (Mendelson's Syndrome) Lancet 1:288-292, 1966.Crossref 36. Salem MR, Wong AY, Mani M, et al: Premedicant drugs and gastric juice pH and volume in pediatric patients . Anesthesiology 44:216-219, 1976.Crossref 37. McCormick PW: Immediate care after aspiration of vomit . Anaesthesia 30:658-665, 1975.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1977

References