A Case of Pulmonary Aspiration during the Anesthetic Induction in the Post Total Gastrectomy Patient / 대한구급학회지

ABSTRACT

Pulmonary aspiration of gastric contents is a feared complication of anesthetic procedures. But aspiration of intestinal contents is rare, the influences of the aspirated contents and/or the consequnt events in the airway have not been fully settled in its provacative role for causing an acute pulmonary reaction. We experienced a case of pulmonary aspiration of intestinal content. The patinet who had undergone previous total gastrectomy was planed emergency operation due to intestinal obstructon. Aspiration during anesthetic induction occurred accidentally. Immediate endotracheal intubation and suction were followed. Right chest breathing sound was coarse and then it was getting better. Although supplement of O2 by Y-piece, arterial blood gas analysis of patient revealed pH 7.30, PaCO2 36 mmHg, PaO2 58 mmHg after emegence from anesthesia in the recovery room. Chest X-ray showed the focal air space consolidation in right lower lung and ill defined pulmonary opacity in left mid lung and retrocardiac area. The measured pH of aspiration content was 7.8 and nonpathogenic Gram negative bacilli species were cutured. Frequent suction, encouraging expectoration, antimicrobial agents therapy and O2 supplementation by Y-piece were performed in the ICU. Patient normalized following 24 hrs after the episode of aspiration.