Pulmonary aspiration during intubation in a high-risk patient: A video clip and clinical implications
10.17245/jdapm.2018.18.2.111
- Author:
Gi Ho KOH
1
;
Sung Hoon KIM
;
Hyo Jung SON
;
Jun Young JO
;
Seong Soo CHOI
;
Se Ung PARK
;
Wook Jong KIM
;
Seung Woo KU
Author Information
1. Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. shkimans@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Hypopharyngeal Cancer;
Intubation;
Respiratory Aspiration
- MeSH:
Anesthesia;
Anesthesia, General;
Esophageal Sphincter, Lower;
Esophagectomy;
Gravitation;
Humans;
Hypopharyngeal Neoplasms;
Incidence;
Intubation;
Respiratory Aspiration;
Stomach
- From:Journal of Dental Anesthesia and Pain Medicine
2018;18(2):111-114
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of pulmonary aspiration during induction of general anesthesia in a patient who was status post esophagectomy. Sudden, unexpected aspiration occurred even though the patient had fasted adequately (over 13 hours) and received rapid sequence anesthesia induction. Since during esophagectomy, the lower esophageal sphincter is excised, stomach vagal innervation is lost, and the stomach is flaccid, draining only by gravity, the patient becomes vulnerable to aspiration. As the incidence of perioperative pulmonary aspiration is relatively low, precautions to prevent aspiration tend to be overlooked. We present a video clip showing pulmonary aspiration and discuss the literature concerning the risk of aspiration and its preventive strategies.
