SEARCH RESULTS FOR: Perioperative-Aspiration-Syndrome

Perioperative Aspiration Syndrome

Perioperative Aspiration: Pathogenesis and clinical findings ↑Intracranial Pressure Head trauma Drug or alcohol overdose Poorly managed perioperative and intraoperative pain Poorly managed gastroesophageal reflux disease History of upper or lower gastrointestinal surgery or obstruction, recent trauma Structural abnormalities (ie: hiatus hernia, incompetent lower esophageal sphincter) Authors: Punit Bhatt Reviewers: Priyanka Grewal Luiza Radu Leyla Baghirzada* *MD at time of publication Changing blood flow/stimulation of nucleus tractus solitarius Insufficient suppression of pain and reflexes Improper positive pressure ventilation Body habitus (pregnant, ascites, obesity, large abdominal tumors) Active labour Initiation of vomiting reflex by nucleus tractus solitarius Altered anatomy Emergency surgery Improper medication cessation (ie: opioid use or continuation of GLP-1 agonists History of gastroparesis Inadequate perioperative fasting Increased intraabdominal and intrathoracic pressure Inadequate gastric emptying and possible regurgitation into upper gastrointestinal tract Neurological or neuromuscular deficits Medication use (ie: local anesthetics) Decreased level of consciousness Air enters the stomach Inadequate anti-emetic and prophylactic therapy Difficulty swallowing or inadequate protective airway reflexes Regurgitation of stomach contents into the airway Fluids or secretions enter the airway Aspiration Inhalation of foreign material into respiratory tract Upper airway obstruction: From pharynx to larynx Fluid aspiration Lower airway obstruction: From trachea to alveoli Destruction of respiratory surfactant Complete airway obstruction No air exchange, no airflow into the lungs (↓ O2 and CO2 exchange) Partial airway obstruction Limited air exchange, some airflow into the lungs ↓ Air entry Narrowed airway Alveolar collapse Bronchodilation on inspiration allows air to enter, despite obstruction ↓ O2 and CO2 exchange Turbulent airflow Mismatch in O2 Hypoxia Turbulent airflow supply & due to narrowed myocardial O2 airway demand Cardiac Arrest Laryngeal Irritation (hoarseness of voice) Acute Respiratory Distress Syndrome ↑ Respiratory drive from brainstem Higher pitch sound ↑ Air velocity ↓ Air entry and incomplete ventilation of lungs Impaired vocal cord function Hypoxia Bronchospasm Hypoxia ↑ Air velocity Bronchoconstriction on expiration seals airway around obstruction Development of one-way valve: air can enter but not escape Higher pitch sound Tachypnea ↑ Work of breathing Expiratory wheeze ↓ Breath sounds Unilateral hyperinflation Inspiratory Stridor ↑ Work of breathing Acute Respiratory Distress Syndrome Diaphragm flattening Increased retrosternal airspace on chest X-Ray Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Aug 12, 2025 on www.thecalgaryguide.com