Aspiration pneumonitis
Contents:
Description:
Aspiration pneumonitis — the pathological syndrome resulting from aspiration of gastric contents in respiratory tracts and which is shown development of signs of ODN with the subsequent accession of an infectious component.
Symptoms of the Aspiration pneumonitis:
Regardless of pathogeny option, at patients three stages of course of this syndrome are observed:
1. The reflex bronkhiolospazm is resulted by ODN I—III of the Art. with a possible lethal outcome from suffocation.
2. If the patient does not perish at the first stage, then in a few minutes as a result of partial spontaneous stopping of a bronkhiolospazm some clinical improvement is noted.
3. In a pathogeny of emergence of the third stage bystry emergence and increase of hypostasis and an inflammation of bronchial tubes lies that causes increase of signs of ODN.
Reasons of the Aspiration pneumonitis:
The most often this syndrome meets in anesthesiology practice when to the patient the general anesthesia against the background of a full stomach is carried out. However this morbid condition can develop also at insolvency of a cardial press (at pregnant women on term 20 — 23 weeks), at heavy alcoholic intoxication, various comas in combination with vomiting or spontaneous aspiration of gastric contents.
Treatment of the Aspiration pneumonitis:
1. Urgent sanitation of an oral cavity and nasopharynx, trachea intubation, transfer into IVL, aspiration sanitation of a trachea and bronchial tubes.
2. Carrying out IVL, using a hyperventilation (FASHION — 15 — 20 l) with inhalation of 100% of oxygen in the PDKV mode.
3. Aspiration of gastric contents.
4. Sanatsionny bronkhoskopiya.
5. Symptomatic, antiedematous and antiinflammatory therapy.
6. At an initial stage of a disease preventive use of antibiotics is not shown since usually aspirirovanny contents (provided that there was no aspiration from intestines at intestinal impassability) are sterile and there are that not less than 24 hours. In the subsequent, at emergence of fever, a leukocytosis and other signs of accession of an infectious component, performing antibiotic treatment is necessary.
7. At aspiration against the background of intestinal impassability immediate purpose of shock doses of antibiotics of a penicillinic row in combination with aminoglycosides is shown.
