Aspiration pneumonia

Overview of aspiration pneumonia (aspiration pneumonitis) is inhaled acidic substances, animal fats such as food, stomach capacity, and other irritation and liquid hydrocarbons of play, caused by the chemical pneumonia. Severe respiratory failure may occur, or respiratory distress syndrome. Clinical inhalation causes gastric contents, pneumonia caused by acid than the inhalation of liquid hydrocarbons styles, and more important. Kerosene, petrol, PCE, furniture polishing agent can sometimes aspiration, more common in children. As jets normal protective reflex and swallowing synergies, general food and difficult access to foreign bodies under the respiratory tract Even a small amount of liquid aspiration, but also emitted by coughing. Not in their right mind when as general anesthesia, cerebrovascular accident, epilepsy, alcoholism, narcotic or tranquilizer overdose. Defense weakened or disappeared, foreign bodies can be inhaled trachea; esophageal diseases such as esophageal missing flaccid disease, cancer of the esophagus on, Vis International Commercial Arbitration Moot 1995/96 diverticulum of the esophagus and esophageal Canal hypopharynx not all, anti-inflow trachea; caused by a variety of reasons tracheoesophageal fistula, Transesophageal food directly into the trachea; iatrogenic factors such as the stomach to stimulate the throat to induce vomiting; Tracheal intubation or tracheostomy impact of laryngeal function and inhibit normal pharyngeal movement can be inhaled vomit airway. The elderly poor response more susceptible to aspiration pneumonia. From inhaling stomach capacity, due to the stimulation of gastric acid, acute lung inflammation, and the severity of their concentration of hydrochloric acid in gastric juice, inhaled in the lungs and the volume of distribution of the. Inhalation of the acid pH ≤ 2.5, a dose of 25 ml that can cause severe lung damage. Animal experiments confirmed that the inhalation of pH "1.5 3 ml of liquid / kg body weight can be lethal. Inhalation Solution spread more widely, the more serious the damage. Pathological changes from inhaling stomach capacity, the immediate cause acid airway and lungs chemical burns. Stimulate the bronchial wall aroused strong cramps, subsequent acute bronchial epithelial inflammatory responses and peripheral bronchial inflammatory infiltration. Enter the gastric lavage quickly spread to the lung tissue, is caused foam cell damage, degeneration, and involving capillary wall, enable increased vascular permeability, vascular fluid leakage caused edema and hemorrhage pneumonia. Moreover, due to the alveolar capillary membrane damage, interstitial pulmonary edema formation. A few days later alveolar edema and hemorrhage within the gradual absorption and was replaced by a transparent membrane. Long it can be formed pulmonary fibrosis. Inhaled foreign body when food or if bacterial throat into the lungs, may lead to the anaerobic bacteria secondary bacterial infection lung abscess formation. Pulmonary edema pulmonary tissue elastic so weakened compliance decreased lung capacity, in addition to pulmonary surfactant reduced so small airway closure, alveolar collapse caused Micro atelectasis may have inadequate ventilation. Ventilation / flow imbalance and static blood streaming increase, or lead to hypoxemia with metabolic acidosis. Intravascular fluid leaking from a large number of vascular or reverse the expansion could cause hypotension. Inhalation of hydrocarbons with the pathologic process similar to acid inhalation, because the low surface tension. immediately after inhaling the proliferation of lung large area and make surfactant inactivation, and easy to atelectasis, lung and water, lead to severe hypoxemia. Patients with clinical manifestations often inhaled incentives history, the rapid onset, more than one-three hours after the onset of symptoms. Clinical manifestations and induced causes, as a result of tracheal - esophageal fistula caused by the inhalation pneumonia, each consumption after spastic cough, short breath. Not in their right mind circumstances, inhaling often no obvious symptoms, but 1 ~ 2 hours after sudden breathing difficulties. rapidly emerging cyanosis and hypotension, cough often serous bubble-like sputum, blood. Wen and wet lungs rales, with Aeromonas songs. Will be serious respiratory distress syndrome. Chest X-ray after inhaling said in a two-hour can be seen scattered in both lungs Flake irregular edge fuzzy shadow Distribution and lung lesions absorbed posture, common in the middle and lower lung fields, the most common right lung. The risk of pulmonary edema, the lungs flake and cloud shadow HAZE integration into large patches, from 2 hilar outward proliferation, to bring within the lungs were clear, with acute cardiogenic pulmonary edema performance of the X-ray similar, but the size and shape of the heart normal No signs of pulmonary venous hypertension. Treatment in emergency situations, be immediately given the high concentration of oxygen inhalation, or application Branchofiberoscope intubation of a foreign body aspiration. increase use of positive end-expiratory pressure of respiratory therapy, "Acute respiratory distress syndrome." Correct inadequate blood volume available albumin or other low molecular weight dextran. To avoid too heavy a burden left ventricle and colloidal liquid leakage human lung interstitial may use diuretics. Paper applications adrenal hormone therapy is controversial, in that 12-hour period inhalation extensive use of glucocorticoids 3 ~ 4, conducive to the absorption of pulmonary inflammation, but also hold the opposite view. Antibiotics only for the control of secondary infection and do not advocate for the prevention of bacterial infection, because medication would not reduce secondary bacterial infection, is likely to have drug-resistant strains. Inhalation of liquid hydrocarbons, the treatment with the same principles. Prevent aspiration pneumonia prevention of the main measures to prevent food or stomach capacity from inhalation, If anesthesia before surgery for gastric emptying full of comatose patients can take the first low and lateral positions early gastric tube placement. necessary for intubation or tracheostomy all work. Strengthening care is even more important.