Aspiration of gastric contents
Contents:
Description:
Aspiration of gastric contents is called inhalation of gastric contents in a tracheobronchial tree.
Symptoms of Aspiration of gastric contents:
Gastric contents are visible in a company to a throat.
Heavy anoxemia.
The raised PDV.
Bronchospasm.
Plentiful tracheal secretion.
Cough, laryngospasm, rattles or retraction of a thorax.
Disturbances of breath, apnoea or tachypnea.
Given to a thorax X-ray analysis:
in 15 — 20% of cases not informatively;
pneumonic infiltrates and atelectases.
Situations with similar signs:
Anoxemia owing to other reasons.
Obstruction of ETT.
Bronchospasm owing to other reasons.
Fluid lungs.
RDSV.
Pulmonary embolism.
Pneumonia.
High PDV owing to other reasons.
Reasons of Aspiration of gastric contents:
Passive regurgitation or active vomiting to gastric contents at the patients deprived of an opportunity to protect respiratory tracts.
Treatment of Aspiration of gastric contents:
If during an intubation emergence of gastric contents is noticed or there was a suspicion on its pulmonary aspiration, immediately execute suction from a trachea prior to ventilation with positive pressure;
if ETT in a trachea, move the patient to situation with the head with raising of the right edge of a table down; carry out a suction catheter to ETT.
If there was an aspiration of solid particles, execute a bronkhoskopiya.
For removal of aspirirovanny particles lavage plus suction can be required.
Take sample of gastric contents for a research рН, crops and a bacterioscopy.
Cancel planned operation. The volume of an immediate surgery has to be limited to the minimum dictated by patient safety. You carry out auxiliary therapy.
Infusional therapy, preferably crystalloids, colloids — according to indications.
For prevention of stressful ulcers educate the patient Н^-блокаторы:
Cimetidinum in/in, 300 mg each 6 h;
ranitidine in/in, 50 mg each 6 h.
It is recommended to carry out a periodic toilet of lungs as the unimpaired ciliate epithelium will continue to push out aspirirovanny particles and edematous liquid in bronchial tubes.
Lavage through ETT is usually not shown. Consider prescription of antibiotics:
the choice of an antibiotic has to be based on results of a bacteriological research of pulmonary aspirate;
preventive prescription of antibiotics is shown at aspiration with impurity of fecal masses.
