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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mendelson's syndrome is discussed with a review of the literature and presentation of 27 personal cases studies. Accidental aspiration of gastric fluid occurs primarily during anesthesia, in cranial trauma victims, and in toxic coma patients. Tissue damage is proportional to the acidity and the quantity of aspirated fluid. The initial clinical manifestations are often serious, sometimes leading to acute respiratory distress syndrom with pulmonary edema. Frequent infectious complications, often with anaerobic microbes, are deciding factors in the prognosis. Artificial ventilation with positive pressure (sometimes continuous) is often necessary. Administration of corticosteroids at high doses is likely favorable. Prophylactic administration of antibiotics is initially directed against anaerobic agents. The prevention of this serious syndrome should be a primary concern of anesthesiologists and physicians treating comatous patients.
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PMID:[Mendelson's syndrome]. 2 27

Clinical studies have long suggested the presence of a specific cardiomyopathy in sickle cell anemia secondary to intracoronary thrombosis and subsequent infarction. Fifty-two autopsy patients were studied (48 with SS hemoglobin, 4 with S-C or S-Thal hemoglobin) to ascertain the range of cardiac pathologic abnormalities associated with this disease. The average age was 17 years (range 1 month to 48 years). Renal failure and infection were the most common causes of death; the former was a more common cause in adults than in children. Right and left ventricular hypertrophy and dilatation were the most common abnormal pathologic findings. No evidence of recent or remote myocardial infarction, coronary thrombosis or arteritis was noted in any patient. Eight patients who were studied with postmortem coronary arteriograms exhibited markedly increased coronary arterial caliber with no evidence of atherosclerosis. Seventeen of the 52 patients studied had clinical evidence of congestive heart failure before death. Of these 17 patients, 7 had moderate to severe left ventricular hypertrophy associated with chronic renal failure and hypertension, 2 had right ventricular hypertrophy with organized pulmonary thrombosis, 2 had rheumatic mitral valve disease and 2 died during the second trimester of pregnancy. Two of the 17 patients thought to have pulmonary edema before death in fact had aspiration pneumonia and hemorrhagic pneumonitis, respectively. The data suggest that cardiac dysfunction in sickle cell anemia can usually be explained by the adverse effect of coexisting disease on the diminished cardiac reserve of chronic anemia. The data do not support the concept of a specific "sickle cell cardiomyopathy".
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PMID:Clinicopathologic analysis of cardiac dysfunction in 52 patients with sickle cell anemia. 15 Jul 86

Five patients are reported who developed evidence of acute lung damage after proved ingestion of paraquat. In two the lung changes resolved; in one an aspiration pneumonia occurred, which was successfully treated, while two developed fatal pulmonary oedema. These pulmonary complications after paraquat intoxication appear more common than the progressive pulmonary fibrosis previously described. It is suggested that acute pulmonary oedema is a response to large doses, usually of Gramoxone, that subclinical lung changes result from small doses, usually of Weedol, and that pulmonary fibrosis occurs after intermediate doses. Preliminary data on plasma paraquat concentrations suggest that these are of value in prognosis.
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PMID:Further clinical observations on the pulmonary effects of paraquat ingestion. 48 82

A follow up of pulmonary function has been performed on three patients having recovered from Mendelson's syndrome (between 1 and 70 months). In the 3 patients a syndrome of diffuse interstitial pulmonary fibrosis was observed. These perturbations disappeared relatively quickly. They were compatible with pulmonary oedema due to the disappearance of surfactant, consecutive to acid inhalation.
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PMID:[A follow up of pulmonary function after Mendelson's syndrome (author's transl)]. 49 9

An assessment of morbidity in near-drowning was made from a review of emergency room and hospital records of 72 patients, ages 9 months to 20 years, who suffered near-drowning during the period January 1972 through June 1974. Fifteen patients (21% evidenced severe anoxic encephalopathy; the remainder had no detectable neurologic deficits. Hypoxemia was demonstrated in 56 patients. Severe acidosis was not present unless respiratory failure occurred. Neither electrolytes, red blood cell hemolysis, nor cardiac arrhythmias presented a problem. Respiratory complications included pulmonary edema, aspiration pneumonia, atelectasis, shock lung, pneumothorax, and pneumomediastinum. All children requiring cardiopulmonary resuscitation in the emergency room suffered anoxic encephalopathy. The occurrence of seizures, fixed and dilated pupils, flaccid extremities, and lack of response to deep pain in the emergency room had almost universal correlation with resultant severe anoxic encephalopathy, as did a submersion period of six or more minutes. The morbidity of near-drowning is significant with regard to the number of children affected and the severity of the central nervous system insult received. The statement by the American Heart Association that resuscitative efforts in children should be continued for periods longer than ten minutes needs reevaluation, since neurologic recovery did not occur in any child requiring cardiopulmonary resuscitation (CPR) in the emergency room. More importantly, new methods of cerebral resuscitation need to be developed and established. In short, medical personnel need to think in terms of cardiopulmonary cerebral resuscitation (CPCR) rather than in terms of CPR.
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PMID:Morbidity of childhood near-drowning. 84 May 54

By means of the case of a patient resuscitated after cardiac arrest attention is brought to the occurring of Mendelson's syndrome in coronary care units. Aspiration pneumonitis following inhalation of acid gastric contents is little known outside of anesthesia, but is likely to occur more frequent than its diagnosis is made. A considerable black number is to be expected, mostly because of the danger that the aspiration itself has not been registered and the pulmonary edema setting in after a latency of several hours is regarded as sequela of the underlying heart disease. But this misunderstanding can have deleterious effects, because therapy has to consider a hypovolemia caused by the fluid loss into the lungs. Therefore pathogenesis and therapy of the lung edema in Mendelson's syndrome are carefully delineated. In patients surviving the acute stage of the disease, further prognosis is favorable: late sequelae have so far not been observed.
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PMID:[Mendelson's syndrome in coronary care units (author's transl)]. 95 Sep 48

Three methods of inducing difficulty in breathing out in spontaneous ventilation are described: by means of a valve attached to an intubation tube (I), with a polyethylene sac secured hermetically on patient's head and connected to a source of oxygen (2), and also with the help of a low-pressure chamber for patient's body (3). Experiments and clinical observations (40 therapeutic seances in 23 children aged from 1 day to 7 years) have evidenced that this method is mostly more advantageous than artificial ventilation, it is highly efficient in treatment of aspiration pneumonia and pulmonary edema, also it may be used with prophylactic purposes following aspiration, artificial ventilation, in the immediate postoperative period, and after hyperbaric oxygenation.
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PMID:[Clinical and experimental grounds for the method of spontaneous respiration with difficult exhalation (lung inflation) in children]. 96 Apr 48

Peptic aspiration pneumonitis (Mendelson's syndrome) results when gastric acid is aspirated into the lung, as may occur during anesthesia. In the present study, 0.1 N HCl was insufflated via the endotracheal tube into pentobarbital-anesthetized dogs in an amount sufficient to cause severe pulmonary damage. At death, the thorax was opened, the lungs grossly examined, and either weighed and desiccated for determination of wet/dry lung weight ratios, rinsed with saline for removal of alveolar surface phospholipids, or homogenized for whole lung phospholipid determination. Gross appearance and wet/dry lung weight ratios indicated severe pulmonary edema. The surface tension values of the lung wash were elevated over control values. Lysophophatidyl-choline (LPC) showed a striking increase over control values. Because LPC is a potent hemolytic agent which builds up in the lung following this pulmonary insult, and because increased hemorrhaging gradually develops following experimental acid insufflation, it is concluded that LPC is most probably causally related to the hemorrhagic pneumonia of Mendelson's syndrome.
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PMID:Aspiration pneumonitis and pulmonary phospholipids. 99 55

Immediate attention must be given to the respiratory system of the heroin abuser; then he should be given naloxone HCl. Search for evidence of use of additional drugs, which may compound problems. Pulmonary edema, aspiration pneumonia and pulmonary embolization are the most common complications. Infections, particularly endocarditis, and cardiac arrhythmia also occur with heroin overdose. Hepatitis is common. Treatment must include not only attention to the presenting symptoms but also referral to a rehabilitation center when possible.
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PMID:Treating heroin overdose. 112 10

Mendelson's syndrome is characterized by bronchoconstriction, intraalveolary pulmonary oedema and insufficiency of the right heart. We report an unusual case of Mendelson's syndrome in infancy. The morphological findings, combined with the discussion of the pathophysiological stages, are presented.
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PMID:[Mendelson syndrome in childhood]. 128 48


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