Pulmonary Acid Aspiration Syndrome Care in Annapolis, MD
Also known as Mendelson’s syndrome, pulmonary acid aspiration syndrome is a dangerous condition in which acid and other stomach contents may enter the airway and ultimately the lungs. This can result in long term issues like pneumonia and short-term complications that may require emergency medical attention.
What Occurs During Pulmonary Acid Aspiration Syndrome?
During anesthesia, intubation (the insertion of a breathing tube into the throat) is the first step. However, for some, intubation may produce a reflex that causes the regurgitation of gastric juices (stomach fluids). These fluids may travel up to where the breathing apparatus has been inserted, but instead of being projected out of the body, end up being redirected into the lungs.
Only a small amount of fluid is needed to cause severe complications; some estimate that only 25ml (5 teaspoons) are required. Because the gastric fluid is highly acidic (a pH of 2.5 or less) a chemical reaction takes place, parenchymal inflammation (increase/swelling of lung tissue). As a result of this acidic pulmonary aspiration (foreign material entering the lungs), the patient may choke.
To make matters worse, because pulmonary acid aspiration syndrome usually occurs during the administration of anesthesia, the patient can’t signal they have a hidden problem breathing—it’s left to the anesthesiologist to deduce. Issues typically arise in under an hour after acidic gastric juices are aspirated.
The first observable symptoms of Mendelson’s syndrome (pulmonary acid aspiration syndrome) include:
- Tachycardia (rapid heart rate)
- Bronchospasm (spasms of the tubes within the lungs, reducing breathing capacity)
- Hypotension (low blood pressure)
- Pulmonary edema (fluid buildup in the lungs)
- Cyanosis (blue discoloration of the skin)
If left untreated, other symptoms may develop, including:
- Increased pressure in pulmonary artery
- Oxygen stats plummet
- Metabolic acidosis (blood pH imbalance due to acid production)
- Pneumonia (chemical pneumonia), and later bacterial pneumonia.
- Empyema (pus in the lungs)
- Bronchopleural fistula (formation of a tunnel “short circuiting” bronchial breathing activities)
- Pulmonary fibrosis (damaged lung tissue)
- Acute respiratory distress syndrome (not enough oxygen being placed into blood via the lungs)
- Cardiac failure (heart attack)
It’s said that well over half of those who develop pulmonary acid aspiration syndrome will succumb to the condition.
Treatment Options for Mandelson’s Syndrome
Diagnostic tests will need to be quickly performed, including a blood gas test, blood culture, ultrasound, CT scan and chest X-ray. Once the pulmonary acid aspiration syndrome has been confirmed treatment can begin. Treatment typically includes a combination of the following:
- 100% 02 should be administered
- Airway suctioning to remove any residual acid
- Gastric decompression to prevent anymore acid being regurgitated
- Patient transfer to an intensive care unit
- Bronchodilators, antacids (before the procedure) and esophageal muscle relaxants can be administered.
- Sellick’s maneuver can be performed to physically close the esophagus with the hands and thus prevent further acid regurgitation
If you’ve had a history of severe gag reflexes, difficulty of intubation, acid reflux, have a short neck or sleep apnea tell your doctor before undergoing a procedure that requires intubation for general anesthesia. The very dangerous condition, pulmonary acid aspiration syndrome (Mendelson’s syndrome) is preventable.
Request more information about pulmonary acid aspiration syndrome care today. Call (410) 567-0667 or contact Dr. Alan Stuart Weiss online.
Annapolis Integrative Medicine Clinic
Address1819 Bay Ridge Avenue
Annapolis, MD 21403
9:30 am - 6:30 pm
Tue: 10:00 am - 6:00 pm
Wed: 10:00 am - 6:00 pm
Thu: 10:00 am - 6:00 pm
Fri: 10:00 am - 5:00 pm