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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Regurgitation and inhalation of acid gastric content, with resultant chemical pneumonitis, remains a common cause of death during anaesthesia. The effects of intravenous glycopyrrolate 0.3 mg on the lower oesophageal sphincter tone was studied in normal human subjects. Glycopyrrolate decreased lower oesophageal sphincter pressure by 0.88 kPa (p less than 0.005). This finding is of clinical importance in the pre-operative preparation of patients presenting for emergency surgery. A drug which decreases lower oesophageal sphincter tone would presumably increase the hazard of gastro-oesophageal reflux and pulmonary aspiration of acid gastric content.
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PMID:The effect of glycopyrrolate (Robinul) on the lower oesophageal sphincter. 63 28

Regurgitation of gastric contents with subsequent aspiration into the lungs contributes significantly to morbidity and mortality in surgical and nonsurgical patients. The consequences of aspiration pneumonitis depend on the volume and the acidity of the aspirate, and the presence of particulate and bacteria in the aspirate. The occurrence of aspiration pneumonitis may be prevented by correction of risk factors, careful monitoring, and appropriate airway management. The goal of aspiration pneumonitis prophylaxis is to minimize pulmonary complications by controlling risk factors for gastric regurgitation, which include gastric pH less than or equal to 2.5, gastric volume greater than 25 mL, lower esophageal sphincter incompetence, and delayed peristalsis. Prophylactic techniques include nasogastric decompression, acid neutralization, acid suppression, and increased gastric peristalsis. The ability of drugs to alter risk factors does not guarantee that aspiration will not occur, but it does reduce the likelihood of secondary respiratory complications. The ideal prophylactic agent should consistently reduce all risk factors, produce a prompt and sustained response, and possess few adverse effects and drug interactions.
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PMID:Reducing the risk of aspiration pneumonitis. 265 99