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

With an ex vivo, isolated, ventilated, perfused canine pulmonary lobe, the effects of various levels of positive end-expiratory pressure (PEEP) were evaluated following acid injury. Following intrabronchial instillation of hydrochloric acid, eight lobes were ventilated with 5 cm of H2O of PEEP, 12 lobes with 10 cm of PEEP, and eight lobes with 15 cm of PEEP during a 4 hour perfusion period. Blood flow was kept constant in all preparations. Lobes with 5 cm of PEEP developed a 39% intrapulmonary shunt and increased their weight by 220%. When PEEP was increased to 10 cm, weight gain was similar (184%), but shunting decreased markedly, to 7%. When PEEP was increased further to 15 cm, shunting remained low (13%), but weight gain increased markedly, to 411% of the initial lobe weight. This study demonstrates the beneficial effects of PEEP in aspiration pneumonia, but it also points out that increasing levels of PEEP can magnify acid-pulmonary injury by causing a further increase in interstitial and intralveolar edema.
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PMID:Aspiration pneumonia: beneficial and harmful effects of positive end-expiratory pressure. 32

Persistent pulmonary hypertension of the newborn (PPHN) characterised by right to left shunting with intense cyanosis is difficult to manage, and in the best of centres carries a 40-60 percent mortality. We report our one year's experience of managing six neonates with PPHN. There were 5 males and 1 female with mean birth weight of 2.59 +/- 0.487 kg and gestation period 39 +/- 2.0 wks and 1 minute Apgar score 2.8 +/- 2.1. Four to six babies were born by cesarean section and 3-6 babies had aspiration pneumonia. All babies presented within 12 hours of age (mean 5.08 +/- 5 hrs) with intense cyanosis and respiratory distress. Diagnosis were confirmed in all by (a) hyperoxia test, (b) simultaneous determination of preductal and postductal paO2 (c) contrast echocardiography and (d) hyperoxia-hyperventilation test. Babies were managed with hyperventilation using mean ventilatory rates of 100 +/- 45 per minute, an inspired oxygen concentration of 100%, peak inspiratory pressures 27 +/- 9 cm of H2O, and expiratory pressures 5 +/- 1.6 cms of H2O, and mean air way pressures of 10.4 +/- 2.7 cms H2O. Alkali therapy was used in 3 of the six babies whereas low dose dopamine was infused in all six babies. Inspite of aggressive ventilatory therapy, only 3 out of 6 babies could be salvaged.
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PMID:Persistent pulmonary arterial hypertension of the newborn. 134 Aug 63

Thirty of 200 ewes died or were euthanatized during a 21-day period following a 1-day accidental exposure to natural gas condensate, a complex mixture of hydrocarbons obtained during collection of natural gas from wells. Despite access to potable well water, the poisoned ewes willingly consumed toxic doses of condensate that contaminated surface water. Eight animals died without premonitory signs; the remainder became ill over the course of a few days to 3 weeks. The principal cause of mortality was aspiration pneumonia, but myocardial degeneration and necrosis, renal tubular damage, gastritis, enteritis, and meningeal edema and hyperemia were also observed. Gas chromatographic analysis identified chemical traces of the hydrocarbons in the tissues, and "fingerprinting," the process of matching chromatographic tracings, provided forensic proof of the contamination source. Atomic absorption spectroscopy and cholinesterase analyses were performed to eliminate the possibility of toxicosis by heavy metal contaminants or other constituents. This appears to be the first reported incidence of natural gas condensate toxicity involving sheep or other ruminants. Although the available literature presents a suggestive pattern of clinical signs and pathologic lesions of petroleum product poisoning, diagnostic investigations should employ detailed analytic examination because each source of petroleum hydrocarbons contains unique sets of components that may produce different toxic effects.
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PMID:Toxicosis in sheep following ingestion of natural gas condensate. 155 62

Over a period of 10 months, we conducted a prospective randomized controlled trial of endoscopic injection for the arrest of peptic ulcer hemorrhage in 84 patients. We injected pure alcohol (PA, 99.8%), 50% glucose in water (G/W), 3% NaCl solution, and normal saline solution (N/S, controls) to stop bleeding. The ultimate success rates in the four groups were: 81% (17/21) in the PA group, 80% (16/20) in the 50% G/W group, 65.2% (15/23) in the 3% NaCl group, and 80% (16/20) in the N/S group (p greater than 0.05). The volume of blood transfusion (mean +/- s. e. m.) for each patient was 1,200 ml +/- 433 ml in the PA group, 1,130 +/- 356 ml in the 50% G/W group, 1,704 +/- 330 ml in the 3% NaCl group, 1,400 +/- 548 ml in the N/S group (p greater than 0.05). The duration of hospitalization (mean +/- s. e. m.) was 5.7 +/- 1.5 days in the PA group, 3 +/- 1.3 days in the 50% G/W group, 6.1 +/- 1.1 days in the 3% NaCl group, and 5 +/- 1.1 days in the N/S group (p greater than 0.05). No complication of perforation or aspiration pneumonia was observed during hospitalization. We suggest that endoscopic injection with the above solutions be used as the first line of therapeutic endoscopy for arrest of peptic ulcer hemorrhage.
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PMID:Endoscopic injection to arrest peptic ulcer hemorrhage: a prospective, randomized controlled trial; preliminary results. 193 73

Twelve horses with clinical symptoms of a gastric disorder were studied by gastroscopy. Symptoms of gastric disorders were periprandial colic, bruxism, ructus and reflux. Preliminary to gastroscopy the horses were fasted for 24 h. Access to water was not restricted. The gastroscopy could be conducted easily using a fiberscope 2.5 m in length and 11 mm in outer diameter. While ulcers were present in the squamous fundus of all horses only one horse showed ulceration of the glandular fundus. Solitary ulcers near the margo plicatus were found in horses with mild clinical symptoms. In contrast, diffuse gastroesophageal ulceration was accompanied by severe clinical symptoms. Four horses were affected by an acute gastroesophageal ulceration with gastric reflux and subsequent aspiration pneumonia. Two of those horses suffered from acute gastric ulceration 3-4 days following laparatomy. All horses were treated with cimetidine (5 mg/kg bwt/q.i.d.) until clinical symptoms ceased.
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PMID:[Stomach ulcers in the horse--clinical and gastroscopic findings in 12 horses (1989-1990)]. 194 86

In this study chest radiographs of 105 patients from an intensive care unit are reviewed to investigate the value in differential diagnosis and control of the course of pulmonary dysfunction. The most helpful criterion in differential diagnosis was the time course of the visible infiltrate on the chest film. Contusion of the lung and aspiration pneumonia showed a steady decrease after an initial maximum, pneumonia and ARDS developed within several days to a maximal infiltration. A rise in extravascular lung water presents with various quickly changing patterns. Pleural effusion, appearance and localisation of the infiltrate are of less value in differential diagnosis. The connection to clinical and anamnestic features is important. There was a good correlation between time course of the radiological visible infiltrate and the intensity of artificial respiration.
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PMID:[Differential diagnosis and follow-up of pulmonary disorders by bedside thoracic imaging of intensive care patients]. 239 79

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

In oil-producing states, the proximity of livestock to drilling operations and production sites often results in poisoning of animals from ingestion of crude oil, condensate, salt water, heavy metals, and caustic chemicals. The heavy metals encountered most frequently are lead from pipe joint compound and arsenicals and chromates used as corrosion inhibitors. Numerous toxic and caustic chemicals are used in drilling muds and fluids. Crude oil and salt water spills are common occurrences around production sites. Pipeline breaks may result in exposure of livestock to crude oil or refined petroleum hydrocarbons. Ingestion of petroleum hydrocarbons may result in sudden death from peracute bloat. The most common cause of illness or death following exposure to petroleum hydrocarbons is aspiration pneumonia, which may cause a chronic progressive deterioration of health, with death after several days or weeks. Cases in which livestock are exposed to oil, salt water, or caustic chemicals, but do not die acutely or from aspiration pneumonia are more frustrating to diagnose. In these cases, parasitism, poor nutrition, and other debilitating diseases must be considered. Anorexia, weight loss, and decreased rumen motility may be caused by a disruption of normal rumen function. Petroleum hydrocarbons, salt water, and caustic chemicals have the potential of altering rumen flora and enzymatic processes as well as damaging the ruminal and gastrointestinal epithelium. The toxicity of petroleum hydrocarbons appears to be related more closely to the volatility and viscosity of the product than to other factors. The more volatile straight chain and aromatic petroleum hydrocarbons have a greater potential for aspiration pneumonia and may produce an anesthetic-like action if absorbed systemically. The more volatile petroleum hydrocarbons also are more irritating to skin and mucous membranes and appear to be more damaging to rumen flora. Treatment of petroleum hydrocarbon ingestion is aimed at preventing aspiration pneumonia and the animal's absorption of highly volatile components. Activated charcoal slurries and, in some instances, vegetable oil may be used to absorb the ingested petroleum or alter its viscosity to minimize absorption and aspiration. These procedures should be followed by the administration of rumenatories or saline cathartics to hasten the evacuation of the gastrointestinal tract. Chronic poor performance animals with anorexia and rumen dysfunction may respond to fresh rumen inoculant, intravenous glucose, and B-complex vitamins. Prognosis primarily hinges on whether or not aspiration pneumonia has occurred. Treatment of aspiration pneumonia rarely is effe
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PMID:Toxicology of oil field wastes. Hazards to livestock associated with the petroleum industry. 266 11

There have been major changes in obstetric and anaesthetic practice since 1946, including the introduction of intravenous infusions, oxytocics, tocolytic drugs, and endotracheal intubation. Some of these may adversely affect pulmonary water balance, which is probably already altered by pregnancy. These changes may have contributed to the increased severity of Mendelson's syndrome in pregnancy and to some extent explain the failure of prophylaxis to reduce maternal deaths.
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PMID:Maternal mortality from Mendelson's syndrome: an explanation? 286 6

Synchronous and asynchronous differential lung ventilation, with or without the application of selective positive end-expiratory pressure (PEEP), has been described. Short-term asynchronous ventilation with differential PEEP as a treatment modality for unilateral lung disease has not been well documented. We report on a 43-year-old accident victim with multiple trauma who developed a severe left-sided aspiration pneumonia which failed to respond to conventional therapy including the application of PEEP. A left-sided double-lumen endotracheal tube was passed and 15 cm and 5 cm H2O PEEP was applied to the left and right lungs respectively. Asynchronous ventilation using two Ambu bags coupled with vigorous physiotherapy and endobronchial suctioning for 40 minutes resulted in a dramatic improvement in both the appearance on chest radiography and arterial blood gas values.
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PMID:Short-term asynchronous ventilation and differential positive end-expiratory pressure in the treatment of aspiration pneumonia. A case report. 388 Sep 32


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