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

Aspiration pneumonitis is an important cause of many anesthetic and non-surgical deaths and complication. One hundred and eight cases from 1964 to 1974 were reviewed to study the factors associated with aspiration pneumonia. Forty surgical and 68 non-surgical patients were evaluated and compared. Predisposing factors included impaired consciousness, esophageal and neurological disorders, cardiac resuscitation, debilitation, presence of a nasogastric tube or tracheostomy. The most common findings in both groups were dyspnea, cough, cyanosis, fever, tachycardia, rhonchi, rales and wheezes. Sputa of 64 patients failed to reveal the precise etiologic agent. High mortality (30%) and morbidity were found in both groups even with optimum treatment. The causes of morbidity in both groups of patients were pneumonia, lung abscess, myocardial infarction, gastrointestinal hemorrhage, and pulmonary embolus. Prevention, with particular attention to high-risk patients and to factors influencing aspiration in groups of surgical and non-surgical patients, is the solution to the problem.
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PMID:Aspiration pneumonia: a ten-year review. 45 16

A young adult chimpanzee died after a brief gastrointestinal illness characterized by profuse soft stool, vomiting and dyspnoea. Necropsy examination revealed a severe typhlitis and colitis with pseudomembrane formation, and acute aspiration pneumonia. Balantidium coli, a common intestinal parasite, was found in large numbers in the mucosal and submucosal layers of the colon and caecum. The inflammation and degree of invasion associated with Balantidium coli indicates that it was a primary pathogen.
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PMID:Balantidiosis in a chimpanzee (Pan troglodytes). 73 67

Three cases of false atrial dissociation (the Deitz-Marques phenomenon) were presented to show the dependence of this phenomenon on dyspnea. 2) The pseudo-P wave of the Deitz-Marques phenomenon coincided with the beginning of inspiration. 3) In a case of silicotuberculosis, the length of the pseudo-fibrillation was nearly equal to that of laborious inspiration. 4) In a case of aspiration pneumonia, every second cardiac contraction was synchronized with the beginning of inspiration two hours before death. 5) In a case of hyperpotassemia, the pseudo-P wave persisted even after the disappearance of the sinus P wave. 6) The pseudo-P wave was not affected by retrograde activation of the atria by the A-V junctional impulse.
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PMID:False atrial dissociation (the Deitz-Marques phenomenon) and its dependence on dyspnea. 121 48

Myotonic dystrophy (MyD) involves a variety of systems. Respiratory disorders are common, namely elevation of diaphragm, alveolar hypoventilation, aspiration pneumonia and sleep apnea. We evaluated respiratory involvement. The subjects were 11 patients with MyD. Also 6 patients with limb girdle muscular dystrophy (LG) were examined to be compared with MyD. Both groups had the similar activities of daily living. All of them never complained of dyspnea. Arterial blood gas studies were performed in supine position and standing position. A new evidence was found that hypoxemia was aggravated and alveolar-arterial oxygen pressure difference was increased in supine position in MyD. Next, pulmonary function tests were done in supine position and sitting position. Functional residual capacity (FRC) were more reduced in supine position in MyD compared with LG. The value to subtract closing capacity from FRC was negative in supine position in MyD, showing closing phenomenon. We propose the mechanism of the aggravation of hypoxemia may be the following. The reduction of FRC caused by respiratory muscle involvement brings out the closing phenomenon. Abnormal uneven distribution of ventilation-perfusion ratio happens and then hypoxemia is worsened in supine position in MyD.
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PMID:[Aggravation of hypoxemia in supine position in myotonic dystrophy]. 129 47

Between 1974 and 1984, 1,188 patients with esophageal malignancies were treated in the Division of Thoracic Surgery of Veterans General Hospital, Taipei. The rate of resectability was 42.6%. Since 1974, the stomach has been used as esophageal substitute, and through 1984, a total of 368 patients were collected. The routes of reconstruction included retrosternal (77.2%), posteromediastinal (7.1%), and intrathoracic (15.7%). The rates of postoperative complications and surgical mortality in these 368 patients were 26.3% and 6.5%, respectively. Leakage of anastomosis was the most frequent complication. The incidence of stricture of esophagogastrostomy was 25.5%. All strictures were relieved by esophageal dilations. An average of 3.9 esophageal dilations were performed per patient (range, 1 to 15). Radical lymph node dissection was not routinely performed in our series. The actuarial 2-year and 5-year survival rates were 26.4% and 7.6%, respectively. Among 76 patients undergoing cervical esophagogastrostomy and surviving for more than 1 year, late complications occurred as follows: acid/bile regurgitation, 46.1%; postprandial fullness of abdomen, 38.2%; dumping syndrome, 13.2%; distended stomach with dyspnea, 11.8%; aspiration pneumonia, 6.6%; and gastric ulcer, 6.6%. Moreover, compared with patients without pyloroplasty, those with pyloroplasty were found to have a higher incidence of bile regurgitation (55.5% versus 8.6%), dumping syndrome (33.3% versus 6.9%), aspiration pneumonia (16.7% versus 3.4%), and gastric ulcer (22.2% versus 1.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gastric substitution for resectable carcinoma of the esophagus: an analysis of 368 cases. 173 71

The authors report a 56-year-old woman with Ramsey Hunt syndrome with multiple cranial nerve paralysis and acute respiratory failure. Five days before admission, she experienced right otalgia and right facial pain and consulted an otolaryngologist of our hospital, who diagnosed the illness as acute parotitis and laryngopharyngitis. One day before admission, she experienced mild dyspnea and general fatigue and came to our hospital emergency room. A chest X-ray film revealed no abnormalities but some blisters were observed around her right ear. The next day, her dyspnea became more severe and she was admitted. A chest X-ray film on admission revealed right lower lobe consolidation, and neurological examination disclosed multiple cranial nerve paralysis, i.e., paralysis of the right fifth, seventh, eighth, ninth, tenth, eleventh, twelfth and left tenth cranial nerve. The serum titer of anti-herpes zoster antibody was elevated to 1,024, and the patient was diagnosed as having Ramsey Hunt syndrome with multiple cranial nerve paralysis. Arterial blood gas analysis revealed hypoxemia with hypercapnea, which was considered to be due to aspiration pneumonia and central airway obstruction caused by vocal cord paralysis. Mechanical ventilation was soon instituted and several antibiotics and acyclovir were administered intravenously, with marked effects. Three months after admission, the patient was discharged with no sequelae except mild hoarseness. Patients with herpes zoster oticus, facial nerve paralysis and auditory symptoms are diagnosed as having Ramsey Hunt syndrome. This case was complicated by lower cranial nerve paralysis and acute respiratory failure, which is very rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of Ramsey Hunt syndrome with multiple cranial nerve paralysis and acute respiratory failure]. 175 19

Bilateral hypoplasia of the soft palate and aspiration pneumonia occurred in a Standardbred foal. The filly was presented with a history of illthrift, dyspnoea, coughing and bilateral nasal discharge. Abnormal sounds (crackels and wheezes) were auscultated over all lung fields and the cervical trachea. Endoscopy revealed a shortened soft palate with a uvula-like mass protruding from the free border into the nasopharynx. Mucopurulent material was present in the trachea. Samples obtained by tracheal wash were submitted for cytology, culture and sensitivity testing. Results indicated a septic inflammatory process. On lateral radiographs of the thorax there were patchy areas of consolidation and air bronchograms. The foal was euthanased. Necropsy confirmed the presence of a palatal defect and aspiration pneumonia of moderate severity. No other congenital abnormalities were present.
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PMID:Bilateral hypoplasia of the soft palate in a foal. 188 97

The present high degree of safety of enteral nutrition is due to improvements in commercial nutritional products and, chiefly, to the respect of well-established rules of administration. Monitoring the equipment consists of making sure, by means of repeated rinsing, that the fine digestive tract prosthesis remains patent. Nutrients are now sterile and easy to use, and their compositions varied and well-balanced. They are very well tolerated in most cases. Monitoring the speed of gastrointestinal (GI) transit is crucial. One must watch for the occurrence of multiple daily stools, due to the speed of administration or to malabsorption, proliferation of exogenous or endogenous pathogens or patient's underlying pathology, and for a gastric fluid residual volume exceeding 150 ml. Regular controls of gastric emptying and of GI prosthesis position prevent the very rare complications that are aspiration pneumonia and unexplained chronic dyspnoea. Possible interference between enteral nutrition and patient's pathology or treatment must be detected and prevented.
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PMID:[Biological and clinical surveillance techniques: problems and complications of enteral feeding]. 190 74

Localized thyroid carcinoma involving the base of the tongue was diagnosed in 3 dogs examined because of a midline cervical mass rostroventral to the larynx. These masses had been present for 4 to 12 months and were firm, nonsensitive, and fixed in position. One dog had progressive dysphagia and dyspnea. Masses were surgically excised together with the base of the tongue and portions of the hyoid apparatus. Severe dyspnea that developed immediately after surgery in 1 dog was managed by tracheostomy intubation for 4 days. Transient dysphagia developed in all dogs. Hydration was maintained by IV fluid administration until water and food of gruel consistency could be swallowed 1 to 6 days after surgery. Consistency of food was gradually thickened to normal, as swallowing improved 6 days to 2 months after surgery. One dog developed aspiration pneumonia that resolved after antimicrobial administration and improved swallowing that prevented further aspiration. After 9 months, 3 years, and 6 years, the dogs were clinically normal.
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PMID:Surgical excision of ectopic thyroid carcinoma involving the base of the tongue in dogs: three cases (1980-1987). 259 48

Nutritional assistance was indicated in 31 patients with an ENT tumour at different stages of treatment and different stages of the disease. These patients presented with disorders of deglutition with false passages (68%), aspiration pneumonia (10%), dysphagia (35%) or denutrition (17%). We used an endoscopic percutaneous gastrotomy kit produced by the Bioser company (pull technique). In 29 patients, the tube was inserted under general anaesthesia in the operating theatre to prevent dyspnoea during introduction of the tube in these patients with alteration of the airway-gastrointestinal tract junction or because the tube was inserted at the beginning of anaesthesia for ENT surgery. The tube was able to be inserted in every case, with cardiac arrest in one patient who was effectively resuscitated without sequelae, two obstructions of the cuff requiring advancement of the tube with a bougie, 2 ruptures of the thread and one case of dyspnoea. Two patients subsequently developed a wound abscess which was drained and one patient required removal of the tube. Follow-up of the patients demonstrated the good tolerance of this tube which was maintained for an average of 2.9 +/- 0.5 months (0.1 to 9 months) without any major complications. 3 benign wound infections, 4 inflammatory reactions, 4 minimal leaks, 1 case of hyperthermia, 12 cases of abdominal distension and 2 cases of displacement of the tube were observed. The weight gain was equal to 4%. The authors believe that this technique of endoscopic gastrostomy should be preferred to surgical gastrostomy.
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PMID:[Percutaneous endoscopic gastrostomy. Indications and results in 31 patients]. 271 44


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